A  HANDBOOK 


MEDICAL  CLIMATOLOaY. 

EMBODYING  ITS  PRINCIPLES  AND  THERAPEUTIC  APPLICATION 

WITH  SCIENTIFIC  DATA  OF  THE  CHIEF  HEALTH 

RESORTS  OF  THE  WORLD. 


BY 

S.  EDAVIN   SOLLY,   M.D.,  M.R.C.S., 

LATE   PRESIDENT   OF  THE  AMERICAN   CLIMATOLOGICAL  ASSOCIATION. 


ILLUSTRATED  IN  BLACK  AXD  COLORS. 


LEA   BROTHERS   &   CO., 

PHILADELPHIA   AND    NEWYOEK. 
1897.  „„.r»v 

STATE  MEDICAL  LIBRARY 

UNIVERSITY  OF  CAl.'vORNIA 

742  NORTH  BROADWAY 


gf7 


Entered  according  to  the  Act  of  Congress  in  the  year  1897,  by 

LEA  BROTHERS  A-  CO., 

In  the  Office  of  the  Librarian  of  Congress.     All  rights  reserved. 


D  O  II  -N"  A  N  .    !■  R  I  X  T  E  K 


TO 

HERMANN    WEBER,  M.D., 

WHO,    BY    PRECEPT   AJfD   PRACTICE,    HAS   CONTRIBUTED 

GREATLY   TO   OUR   SCIENTIFIC   KNOWLEDGE 

OF   CLIMATE   AND    ITS   USES, 

THIS  BOOK 

IS   GRATEFULLY    DEDICATED   IN   REMEMBRANCE 
OF    MUCH   PERSONAL   KINDNESS. 


PREFACE. 


The  non-existence  of  a  systematic  treatise  on  medical  clima- 
tology, and  the  fact  that  this  subject  has  engaged  the  author's  at- 
tention for  thirty  years,  may  be  advanced  as  the  reasons  for  the 
preparation  of  this  volume.  The  time,  moreover,  seems  ripe  for 
such  an  endeavor,  for  there  is  a  growing  appreciation  both  on  the 
part  of  the  profession  and  the  public  at  large  as  to  the  value  of 
climate  in  the  prevention  and  treatment  of  disease,  and  fortunately 
to  answer  this  awakening  we  have  now  accumulated  accurate  and 
extended  meteorological  observations  upon  which  to  found  natural 
laws  affording  trustworthy  conclusions. 

In  the  endeavor  to  accomplish  the  purpose  above  outlined  the 
author  has  collated  and  compared  climatic  observations  from  all 
parts  of  the  world  up  to  the  present  time,  and  has  sought  to  sys- 
tematize the  work  of  others  with  his  own  experience.  It  is  hardly 
too  much  to  say  that  it  is  possible  to  prescribe  a  climate  Avith  as 
much  precision  as  a  drug,  and  with  far  greater  effect  in  appropriate 
cases.  If  the  present  volume  contributes  to  the  establishment  of 
climatology  in  its  proper  place  as  one  of  the  most  definite  and 
useful  of  the  medical  sciences,  its  purpose  will  be  fulfilled. 

European  nations  have  long  since  recognized  the  therapeutic  and 
financial  value  of  their  health-resorts,  but  Americans  are  only  now 
coming  to  appreciate  the  equal  resources  of  their  own  continent. 
The  United  States  Government  observations  have  been  conducted 
with  wisdom,  and  in  connection  with  the  special  climatic  studies  of 
physicians  have  now  covered  practically  the  entire  country.  Its 
position  and  extent  are  such  that  climates  of  almost  every  variety 
and  excellence  can  be  found  within  its  borders,  and  the  rapid  growth 


Vlll 


PREFACE. 


of  population  aud  railroad  facilities  has,  by  creating  improved  ac- 
commodations, brought  into  practical  use  numerous  resorts  suited 
even  to  the  most  fastidious  health-seeker. 

This  work  is,  however,  as  before  stated,  not  limited  to  the  clima- 
tology of  any  country,  but  essays  to  report  the  typical  climates  of 
the  world.  Comprehensive  and  comparative  climatic  studies  have 
been  introduced,  with  tables  affording  opportunities  of  comparing 
European  and  American  climates.  A  twofold  benefit  is  derivable 
therefrom,  for  in  the  first  place  American  Government  investiga- 
tions throw  additional  light  on  the  principles  of  climatology,  so  that 
physicians  have  a  broader  basis  on  which  to  found  climatic  prescrip- 
tions; and  secondly,  in  comparing  the  better  known  European  resorts 
with  those  of  America  the  physician  can  form  conclusions  from 
data  beyond  the  reach  of  local  prejudice  and  interest. 

Three  classes  of  persons  are  interested  in  the  subject  of  which 
this  work  treats,  but  they  have  not  hitherto  been  supplied  with 
adequate,  modern  and  systematic  information  concerning  it.  The 
present  generation  of  physicians  who  prescribe  travel,  the  travelers 
themselves,  and  the  rising  generation  of  medical  students  should  be 
taught  to  recognize  the  principles  of  medical  climatology  and  its 
proper  relation  to  general  therapeutics.  To  meet  the  needs  of  these 
three  classes  the  author  has  sought  far  and  wide  for  facts,  has 
endeavored  to  form  theories  on  this  foundation,  and  finally  to 
deduce  reasonable  conclusions  from  them.  So  far  as  is  consistent 
with  clearness  and  accuracy,  technicalities  have  been  avoided. 

The  author  takes  this  opportunity  to  express  his  gratitude  to 
his  brethren  in  the  profession,  and  especially  to  his  fellow-mem- 
bers of  the  American  Climatological  Association,  who  so  cour- 
teously responded  to  his  request  for  information,  and  to  Professor 
AV.  ]M.  Davis,  of  Harv^ard  University,  for  his  kind  and  valuable 
criticisms  upon  certain  of  the  meteorological  portions  of  this  work. 

The  section  of  the  book  which  includes  the  meteorological  tables 
was  under  the  charge  of  Mr.  E.  N.  Peirce,  at  whose  disposal  were 
placed  all  data  concerning  the  various  climates,  together  with  criti- 


PREFACE. 


IX 


cisms  and  details  from  the  author's  personal  experience,  and  to  him 
belongs  the  chief  credit  of  analyzing,  digesting  and  setting  forth 
the  information  which  was  essential  in  regard  to  many  of  the 
health-resorts  and  weather-tables.  Without  such  able  co-opera- 
tion, it  would  have  been  impossible  amidst  the  claims  of  active 
practice  to  carry  out  adequately  this  laborious  portion  of  the  book. 

S.  EDWIN  SOLLY. 

Colorado  Springs,  Coi..,  May,  1897. 


CONTENTS 


PAGE 

General  Introduction 17 


SECTION   I. 

CHAPTER   I. 
The  Principles  of  Medical  Climatology 21 

CHAPTER  II. 

PHYSI0L0C4Y 39 

CHAPTER   III. 
Ethnology 48 

CHAPTER  IV. 
Geographical  Distribution  of  Disease 53 

CHAPTER   V. 
Classification  of  Climates 57 


SECTION   II. 

Introduction 71 

CHAPTER  VI. 
Phthisis 73 

CHAPTER  VII. 
Forms  of  Phthisis  as  Influenced  by  Climate     ....    117 

CHAPTER  VIII. 
Results  of  the  Treatment  of  Phthisis  by  Change  of  Climate  .    126 


xii  CONTENTS. 

CHAPTER   IX. 

PAGE 

Forms  of    Disease   other  than    Phthisis  as    Influenced  by 
Climate 146 


SECTION    III. 

Introduction 183 

CHAPTER  X. 
North  America 185 

CHAPTER   XI. 
Eastern  Climates 194 

CHAPTER  XII. 

Southern  Climates 220 

CHAPTER   XIII. 
Rocky  Mountain  Region 237 

CHAPTER   XIV. 
Pacific  Slope  Region 302 

CHAPTER   XV. 
Mexico 355 

CHAPTER  XVI. 
South  America 367 

CHAPTER  XVII. 
Europe 374 

CHAPTER   XVIII. 
Africa — Asia — Australasia 420 

CHAPTER   XIX. 
Island  Climates ....    434 

CHAPTER   XX. 
Meteorological  Tables 451 


MEDICAL  CLIMATOLOGY 


If  we  consider  how  great  a  sacrifice  of  time,  money,  inclination, 
and  affection  is  involved  wheu  au  invalid,  under  direction  of  a 
physician,  leaves  his  home  and  journeys  into  another  and  perhaps  a 
far  country,  we  marvel  at  the  small  amount  of  thought  and  study 
that  is  bestowed  by  the  majority  of  physicians  upon  the  science  of 
medical  climatology;  for  without  a  fair  knowledge  and  appreciation 
of  this  no  rational  selection  of  climate  can  be  made. 

The  deficiency  begins  with  the  medical  schools,  which  should  teach 
at  least  the  broad  principles  of  climatology  and  the  outlines  of 
climatic  therapeutics.  What  would  be  thought  to-day  of  the  physi- 
cian who  diagnosed  and  prescribed  for  a  disease  of  some  organ  of 
whose  structure  and  physiology  he  was  ignorant,  or  of  the  surgeon 
who  proceeded  to  operate  upon  parts  the  anatomy  of  which  he  had 
not  studied  ?  \Yhy,  then,  should  a  physician  presume, -as  so  many 
do,  to  prescribe  a  climate  without  having  acquainted  himself  with 
the  meteorological  facts  and  climatic  data,  and  with  their  meaning 
and  significance  ? 

On  turning  to  the  mass  of  literature  available  upon  climato- 
logical  subjects  we  find  it  largely  composed  of  empirical  and  biased 
accounts  of  various  health-resorts,  and  that  these  reports  differ  little 
in  their  statements  of  the  advantages  to  be  derived.  Commonly, 
each  claims  for  its  own  resort  the  ability  to  cure  all  diseases,  and 
the  only  invalids  warned  against  coming  are  those  in  whom  dis- 
ease is  far  advanced.  The  facts  given  are  few,  and  logical  deduc- 
tions from  them  are  rare.  In  despair  of  making  a  choice  from 
such  sources,  the  physician  is  apt  to  take  the  casual  opinion  of 
patients  or  of  other  laymen  who  have  visited  certain  resorts,  and 
to  select  the  climate  accordingly.  He  cannot,  however,  form  a 
correct  judgment  from  such  information  unless  he  has  previously 
grounded  himself  in  the  fundamental  principles  of  climatology  and 
studied  the  recorded  facts, 

2 


18  MEDICAL  CLIMATOLOGY. 

In  this  desert  of  rubbish  there  are,  nevertheless,  bright  oases  of 
truth  and  reason,  such  as  are  to  be  found  in  the  writings  of  Weber, 
Hirsch,  Jourdanet,  Lombard,  Vivenot,  Rohden,  Copland,  Davidson, 
Denison,  Yeo,  the  Williamses  (father  and  son),  and  others. 

In  choosing  a  health-resort  for  a  given  case  it  is  not  sufficient 
to  select  a  locality  the  merits  of  which  have  been  most  loudly  and 
persistently  exploited  by  its  advocates.  That  which  the  investigator 
discovers  to  be  at  once  his  chief  necessity  and  his  chief  difficulty  is 
the  institution  of  a  close  comparison  of  weather  from  actual  facts; 
therefore,  accurate  meteorological  tables  of  comparison  have  been, 
as  far  as  the  limited  data  allowed,  prepared  for  this  treatise. 

Unfortunately,  meteorological  data  concerning  many  resorts  are 
non-existent,  incomplete,  or  scanty;  and  without  a  sufficient  knowl- 
edge of  these  facts  no  real  estimate  of  the  climate  can  be  made. 
As  an  illustration,  the  Adirondack  region,  so  justly  prized  as  a 
breathing-space  and  playground  for  the  sick  and  weary  of  the 
Atlantic  seaboard,  is  a  melancholy  example  of  neglect  in  meteoro- 
logical accounting  by  the  stewards  of  that  noble  heritage.  Official 
reports,  such  as  those  of  the  United  States  Weather  Bureau,  are 
used  when  obtainable  regarding  any  of  the  localities  mentioned, 
and  are  supplemented  by  reliable  reports  of  local  observers,  and 
much  correspondence  has  been  entered  into  to  gain  fresh  knowl- 
edge. 

Admirable  as  is  the  work  of  the  United  States  Weather  Bureau, 
unfortunately,  through  the  misguided  frugality  of  Congress,  much 
valuable  material  has  had  to  be  omitted  from  the  reports  of  the 
health-stations  of  the  United  States  of  America.  The  humidity- 
observations  have  not  been  taken  at  all  at  some  resorts,  and  in  no 
case  have  they  been  frequent  enough  during  the  twenty-four  hours 
to  allow  of  ascertaining  accurately  the  comparative  condition  of  the 
air  with  regard  to  moisture  throughout  both  the  day  and  night.  This 
defect  has  been  remedied  as  far  as  possible  in  these  pages.  For 
instance,  by  working  the  problem  out,  even  with  the  imperfect 
material  at  hand,  something  is  done  to  reconcile  the  conflicting 
assertions  frequently  made  about  the  coast  climate  of  Southern 
California,  one  being  that  the  climate  is  dry,  and  the  other  that  it 
is  damp.  Careful  study  of  the  meteorological  material  available 
shows  that  the  term  "■  moderately  dry"  can  usually  be  applied  to 
the  midday  hours,  but  from  about  sundown  to  about  10  a.m.  the 
adjective  "  damp"  is  correctly  applicable. 


GENERAL  INTRODUCTION.  19 

The  night-temperatures  have  been  given  when  possible,  also  the 
hours  of  sunlight  in  the  notable  mountain-resorts,  all  of  which  is 
most  important  in  understanding  what  the  customary  weather  is 
during  the  invalid's  day,  and  what  he  may  expect  at  night  while 
under  cover. 

An  effort  has  been  made  to  present  as  many  new  facts  as  possible 
about  useful  but  comparatively  unknown  resorts,  and  even  about 
districts  which,  although  not  as  yet  readily  accessible,  possess  valu- 
able qualifications  for  the  invalid.  On  the  other  hand,  resorts,  par- 
ticularly in  Europe,  of  which  the  literature  is  already  ample  and 
trustworthy,  are  briefly  described,  except  the  more  characteristic 
and  important.  It  seemed  wisest  to  occupy  most  of  the  space  with 
new  and  useful  information  not  contained  in  other  l)Ooks,  and  to 
state  briefly  the  essentials  of  what  can  be  found  elsewhere  at  greater 
length. 

In  order  that  this  book  may  be  more  conveniently  studied  with 
the  least  possible  expenditure  of  time  and  labor  I  have  divided  the 
subject-matter  into  three  sections.  The  first  of  these  deals  broadly 
with  the  principles  of  medical  climatology,  and  describes  the  close 
connection  of  this  science  with  physics,  meteorology,  ethnology, 
geographical  pathology,  etc.  The  second  section  treats  of  the  thera- 
peutics of  climate  in  relation  to  disease.  No  attempt  has  been 
made  under  this  head  to  prescribe  special  climates  for  special  dis- 
eases, and  it  is  obvious  that  as  considerations  so  many  and  so  different 
enter  into  the  fitting  of  the  individual  case  to  the  particular  climate, 
this  would  be  a  futile  effort.  The  third  section  is  devoted  to  a 
description  of  special  climates  as  typified  in  selected  resorts,  and 
includes  comparative  and  other  tables. 


SECTION  I. 


CHAPTER   I. 

THE  PEINCIPLES  OF  MEDICAL  CLIMATOLOGY. 

In  order  to  appreciate  the  relations  of  medical  climatology  to 
general  climatology  it  will  be  well  to  give  some  brief  definitions  to 
explain  the  sense  in  which  certain  terms  are  used  throughout  this 
treatise. 

Weather  consists  of  the  individual  atmospheric  conditions  expe- 
rienced from  day  to  day. 

Climate  consists  of  the  average  values  of  the  current  weather- 
conditions,  with  their  ranges,  in  a  giv^en  locality,  taken  in  connection 
with  its  latitude,  elevation  and  topography,  soil  and  vegetation. 

Thus  the  weather  in  a  health-resort  may  be  good,  bad,  or  excep- 
tional at  any  given  time  or  season,  while  its  climate  may  remain  the 
same  for  the  season  or  year  as  the  constant  elements  modify  the 
transitory  peculiarities  of  the  weather. 

Meteorology,  a  term  often  used  interchangeably  with  clima- 
tology, is  the  study  of  both  weather  and  climate;  but  it  may  be 
understood  to  deal  more  particularly  with  the  detailed  methods  of 
recording  and  predicting  weather  and  the  formation  of  deductions 
from  the  summarizing  and  comparing  of  the  records  of  the  various 
climates. 

Climatolog-y  is  the  study  of  the  climates  of  the  various  parts  of 
the  earth's  surface  and  their  relations  to  each  other;  it  is  either  pure 
or  applied.  It  may  be  considered  to  embrace  not  only  the  meteor- 
ology of  the  various  climates,  but  the  meteorological  data  in  connec- 
tion with  the  elevation,  latitude,  topography,  soil,  and  vegetation  of 
a  region. 

Pure  climatology  is  the  study  of  climates  irrespective  of  their 
effects  upon  life,  either  vegetable  or  animal. 

Applied  climatology  is  the  science  of  climatology  with  respect 
to  the  influence  of  climate  upon  some  particular  form  or  order  of 


22 


MEDIC  A  L  C  LI  31  A  TOL  OGY. 


life.  When  applied  to  the  growth  of  crops,  edible  herbs,  or  fruits, 
it  may  be  termed  agricultural  climatology;  when  to  ornamental 
shrubs  or  plants,  horticultural;  and  so  on  through  the  various  de- 
partments of  vegetable  life. 

With  respect  to  the  applications  of  climatology  to  the  animal 
world,  they  may  be  divided  into  various  groups,  those  with  which 
we  are  concerned  being  the  physiological,  pathological,  and  thera- 
peutical. The  combination  of  these  three,  limited  in  their  applica- 
tion to  man,  constitutes  medical  climatology. 

Medical  climatology,  in  the  arrangement  of  its  various  depart- 
ments, may  be  compared  to  a  pyramid,  the  base  of  which  is  formed 
of  the  study  of  climatic  physics ;  this  includes  the  essence  of  meteor- 
ology and  certain  divisions  of  geography,  geology,  botany,  and 
zoology. 


The 
Indi- 
vidual CsLSe^ 
and  its  Appro- 
priate Climate. 

Study  of  Special 
Climates  and  Regions. 

Individual  Climatotherapy. 

General  Climatotherapy. 

Classification  of  Climates. 

Geographical  Pathology,  or  the  Distribution  of  Disease. 

Ethnology,  or  the  Distinctions  of  Race. 

Physiology  :  the  General  and  Particular  Influences  of  Climate 
upon  the  Human  Organism. 


Climatic  Physics :  including  portions  of  Meteorology,  Geography,  Geology,  Botany, 

and  Zoology. 


Resting  upon  this  foundation  is  the  tier  formed  by  the  physiologic 
effects  of  climate;  this  is  the  study  of  the  influence  of  the  various 
physical  elements  of  climate,  first  separately  and  then  in  combina- 
tion, upon  the  normal  human  being;  the  primary  considerations 
being  the  influence  which  it  exerts  upon  special  organs  and  func- 


THE  PRINCIPLES  OF  MEDICAL  CLIMATOLOGY.  23 

tions,  and  the  secoudaiy  that  brought  to  bear  "upon  the  human 
organism  as  a  whole. 

The  next  department,  or  tier,  in  the  pyramid  is  ethnology,  which 
deals  with  the  distinctions  of  race;  how  their  location  has  been  de- 
termined through  their  selection  of  a  climate  on  account  of  their 
requirements  or  by  reason  of  their  necessities,  and  how  their  char- 
acteristics become  modified  by  climatic  influences,  first  as  to  physio- 
logic peculiarities  and  next  as  to  pathologic.  Thus  we  have  placed 
upon  the  layer  of  physiology  one  of  ethnology,  and  upon  this  again 
a  tier  of  geographical  pathology,  by  which  we  are  taught  the  special 
tendencies  and  dangers  of  each  climate. 

Next,  the  classification  of  climates  should  claim  our  attention. 

We  have  now  arrived  at  a  sufficient  elevation  in  our  pyramid  of 
knowledge  to  continue  the  building  up  of  our  structure  with  climatic 
therapeutics,  beginning  with  a  tier  composed  of  general  climato- 
therapy;  that  is,  a  consideration  of  what  diseases  and  what  stages 
and  forms  of  them  are  likely  to  be  benefited  by  climatic  change,  and 
the  particular  climate  suited  for  special  diseases.  Then  follows  the 
study  of  the  influence  of  climate  upon  the  various  temperaments 
and  diatheses ;  next  the  study  of  special  climates  and  regions  ;  and, 
finally,  the  apex  is  reached  of  the  individual  case  and  its  appropriate 
climatic  treatment. 

PHYSICS. 

Six  elements — namely,  earth,  air,  water,  sunlight,  temperature, 
and  electricity — by  their  various  proportions  and  modifying  influ- 
ences upon  each  other,  go  to  make  a  climate.  In  order  to  appreciate 
the  fundamental  causes  of  the  varieties  and  results  of  climate  it  is 
necessary  to  disentangle  arbitrarily  what  are  always  closely  related 
in  nature,  and  so  make  certain  subdivisions  of  these  six  elements. 

The  first  climatic  factor  of  the  elements  enumerated  is  earth. 
This  admits  of  two  chief  divisions,  viz.,  composition  and  config- 
uration, its  composition  giving  rise  to  two  subdivisions,  viz.,  soil 
and  vegetation,  or  inorganic  and  organic  elements,  and  the^e  being 
again  divided  as  shown  on  page  24: 


24  MEDICAL  CLIMATOLOGY. 

{  Eock. 
r  -.  .1   Garden-soil. 

I  I°org^"^«     \  Clay. 

f  Composition    -|  I  Saud  and  gravel. 

I  I  J  Trees. 

Earth   J  ^  Organic  Grass. 

I  Plants. 

f  Plains. 

•^  Configuration J  Mountains. 

^  Valleys. 

Air  is  a  mixture  of  nitrogeo,  argon,  carbonic  acid,  and  oxygen, 
and  contains  also  water-vapor,  ozone,  and  varying  amounts  of  other 
gases,  germs,  dust,  fogs,  cloud-particles,  etc. 

Position.  Latitude,  that  is,  distance  from  the  eq^uator  (tempera- 
ture decreasing  and  barometric  pressure  increasing  from  the  equator 
to  latitude  30°  and  then  generally  decreasing  toward  the  poles). 

Altitude.  Height  above  sea-level  (barometric  pressure  decreas- 
ing whilst  rising  from  the  sea-level). 

Distance  from  the  ocean,  o-ivino;  rise  to  divisions  into: 

r  Ocean  air. 

Sea  air \  Shore  air. 

'  Island  air. 
Plain  air. 

Inland  air {  Mountain  air. 

Valley  air. 
Wind. 


Mobility  of  air 

(  Calm 

Water.  Composition  :  hydrogen  and  oxygen  chemically  com- 
bined, accompanied  by  more  or  less  salts  and  frequently  vegetable 
and  animal  impurities. 

Localized  "Water.     As  in  seas,  lakes,  streams,  and  springs. 

Mobilized  Water.  As  in  clouds,  mists,  fogs,  rain,  snow,  hail, 
and  dew. 

Vaporized  Water.    That  is,  the  water-vapor  of  the  atmosphere. 

Absorbed  Water.  As  present  in  solid  bodies,  soils,  rocks,  and 
vegetation. 

[Daylight  {^;;°f°"- 

c  I  I  Shade. 

Sunlight       \ 

J  Darkness. 

^       ^  I  Moonlight  and  starlight. 


THE  PRINCIPLES  OF  MEDICAL  CLIMATOLOGY.  25 

Temperature    .     .     .     .     j  ■^^**^- 

{  Cold. 


Constant 
I 
Electricity  \ 


^  rionafflnt       |  Negative  on  the  earth's  surface. 
I  Positive  in  atmosphere. 


Inconstant   I  Thunderstorms  and  other  electri- 
{  t-       cal  disturbances. 

EARTH. 

The  ground  exerts  a  most  important  influence  upon  the^  tem- 
perature and  humidity  of  the  air  immediately  overlying  it^  which  is 
nearly  of  the  same  moisture  and  warmth  as  the  ground  itself.  The 
various  soils  receive  and  retain  heat  and  air  very  differently,  and 
also  absorb  and  hold  moisture  in  very  different  proportions,  and  a 
common  defect  in  climatic  reports  is  the  absence  of  accurate  state- 
ments about  the  soil,  which  often  varies  greatly  even  in  different 
parts  of  the  same  resort,  both  in  its  quality  and  state  of  cultivation. 
Ground-moisture,  as  is  well  known,  tends  to  promote  the  develop- 
ment of  phthisis  and  rheumatism,  and,  when  accompanied  by  heat 
and  decaying  vegetation,  produces  malarial  fevers. 

Vegetation  influences  climate,  increasing,  when  luxuriant,  the 
humidity  of  both  soil  and  air.  The  degree  to  wdiich  this  influence 
is  exerted  depends,  however,  upon  the  character  of  the  vegetation, 
evergreens  fostering  much  less  dampness  than  deciduous  trees,  and 
meadows  less  than  ploughed  lands. 

Plains  are  most  open  to  the  sweep  of  storms;  when  dry  they 
heat  and  cool  rapidly,  the  difference  in  temperature  between  day 
and  night  being  very  marked. 

Mountains.  Clouds  form  quickly  in  the  cooled  air  around  moun- 
tains, and,  remaining  for  the  most  part  stationary  around  the  peaks, 
diminish  radiation  and  so  lessen  extremes;  damp  winds,  however, 
bring  clouds  which,  instead  of  rising  and  hanging  on  the  peaks, 
tend  to  blow  across  the  slopes  and  valleys  and  so  produce  rain  and 
snow  and  lowering  of  temperature  upon  the  windward  side  of  the 
mountain,  while  the  other,  or  lee  side,  is  warmer  and  drier.  Val- 
leys vary  much  in  climate  as  they  happen  to  be  sheltered  or  exposed 
to  winds,  storms,  and  sunlight,  and  even  opposite  sides  of  a  valley 
sometimes  show  marked  contrasts.  The  question  of  the  number  of 
hours  of  sunlight  is  always  an  important  one  to  consider  in  choos- 
ing a  valley  as  a  place  of  residence,  and  what  it  gains  in  shelter  it 
may  sometimes  lose  in  ventilation.      Humidity  is  increased  by  the 


26  MEDICAL  CLIMATOLOGY. 

proximity  of  glaciers  and  snow-fields,  and  this  is  especially  notice- 
able in  the  spring  when  they  are  melting. 

AIR. 

Air  brings  to  us  most  of  the  other  elements  and  is  the  chief  sup- 
porter of  life,  and  yet,  while  we  make  minute  inquiries  into  our 
water-supply,  we  are  apt  to  neglect  the  question  of  air,  which  we 
use  in  far  greater  quantities.  This  is  all  the  more  to  be  wondered 
at  because  water,  before  and  during  its  passage  to  the  stomach,  is 
subjected  to  the  qualifying  influences  of  cooking,  association  with 
food,  etc.,  but  air  goes  through  far  less  modification  in  its  passage  to 
the  lungs. 

Oxyg-en  and  Carbonic  Acid,  A  very  slight  deficiency  of  oxy- 
gen or  a  very  small  increase  of  carbonic  acid  in  the  air  we  breathe 
is  of  much  importance. 

Ozone,  which  is  allotropic  oxygen,  is  never  present  in  the  atmos- 
phere in  a  greater  proportion  than  1  in  700,000.  It  is  a  powerful 
disinfectant  and  is  most  abundant  in  open  places,  such  as  the 
ocean  or  desert-plains,  and  on  mountains,  and  is  also  plentiful 
in  pine- woods;  it  is  increased  by  strong  sunlight  and  thunder- 
storms. 

Dust,  Germs,  and  other  Foreign  Bodies.  These,  in  a  greater 
or  less  amount,  are  always  found  floating  in  the  air  of  cities,  offices, 
and  workshops,  while  germs  are  only  scantily  present  in  the  atmos- 
phere of  the  ocean,  or  of  arid  plains  and  mountain-slopes;  this 
absence  of  poisonous  and  irritating  substances  is  doubtless  one  of 
the  chief  merits  of  open  spaces  as  resorts  for  invalids. 

Latitude — that  is,  the  relative  distance  of  a  given  resort  from  the 
equator — largely  influences  a  climate,  both  because  the  temperature 
declines  with  distance  from  the  equator  (more  rapidly  in  the 
northern  than  in  the  southern  hemisphere),  and  because  of  the 
variation  in  the  density  of  the  atmosphere — that  is,  the  barometric 
pressure.  In  consequence  of  the  heating  of  the  air  at  the  equator  it 
expands,  and  thus,  becoming  lighter,  it  is  raised  into  the  upper 
regions  and  flows  toward  the  poles,  where,  being  cooled,  it  again 
contracts,  and  becomes  heavier,  sinks,  and  moves  from  the  poles 
toward  the  equator,  to  be  once  more  warmed  and  to  mount  upward. 
Thus  there  are  always  two  constant,  steady  currents  of  cool  air 
flowing  over  the  earth's  surface  from  the  poles  toward  the  equator. 


THE  PRINCIPLES  OF  MEDICAL  CLIMATOLOGY.  27 

one  from  the  north  pole  and  one  from  the  sonth.  Both  are  modi- 
fied by  certain  causes,  which  will  be  spoken  of  later. 

Altitude.  As  the  air-pressure  steadily  diminishes  with  the 
height  of  the  land,  the  column  of  air  above  an  elevated  place  weighs 
less  than  at  sea-level.  For  instance,  at  Potosi,  Bolivia,  13,300 
feet  elevation,  it  is  only  one-sixth  as  dense  as  at  sea-level.  But 
this  difference  in  barometric  pressure  is  modified  by  local  causes 
which  produce  periodical  and  accidental  variations. 

Distance  from  the  Ocean.  As  we  leave  the  ocean  and  approach 
the  centre  of  a  continent  the  land  rises,  and,  therefore,  the  weight 
of  the  atmosphere  diminishes,  as  does  also  the  humidity  by  reason 
of  our  being  further  removed  from  the  influence  of  the  evaporation 
of  the  sea-water. 

These  general  conditions  are,  of  course,  often  modified  by  local 
causes:  as  where  the  land,  in  small  areas,  is  depressed,  or  where 
the  humidity  of  any  section  of  country  is  increased  by  the  presence 
of  great  lakes  or  inland  seas. 

Currents  and  "Winds.  It  was  stated  in  the  definition  of  lati- 
tude that  the  movement  of  the  air  which  surrounds  us  is  southerly 
in  the  northern  hemisphere,  and  northerly  in  the  southern  hemi- 
sphere, while  the  higher  currents  move  in  the  opposite  direction. 
This  general  direction  is,  however,  greatly  modified  by  the  inter- 
position of  seas  and  mountains,  and,  moreover,  the  usual  daily 
course  of  the  wind  is  often  controlled  by  local  influences  which 
temporarily  overcome  these  general  causes. 

Besides  these  main  directions  of  the  winds,  which  are  caused 
by  permanent  differences  in  the  barometric  pressure  and  the  tem- 
perature at  the  equator  and  at  the  poles,  the  rotatory  movement  of 
the  planet  causes  more  or  less  obliquity  in  the  direction  of  the  wind. 
The  seasons,  by  reason  of  the  varying  position  of  the  earth  and  the 
sun,  also  modify  the  direction,  while  the  difference  in  conduction 
and  convection^  over  land  and  water  brings  about  further  modifi- 
cations. 

1  "Convection  is  a  process  by  which  unlilie  temperatures  are  partially  equalized  in  liquids 
or  gases.  This  is  of  great  importance  in  the  atmosphere.  It  may  be  first  illustrated  by  a  simple 
example  in  the  case  of  water : 

"  When  a  vessel  of  water  is  heated  at  the  bottom  the  warmed  layer  is  expanded  and  thus 
made  lighter  than  an  eciual  volume  of  cooler  water  above  it.  In  consequence  of  this  unsteady 
arrangement  the  heavier  overlying  water  is  drawn  downward  by  gravity,  displacing  the  bottom 
layer,  which  then  rises  to  the  surface.  It  is  our  common  habit  to  say  that  the  warm  lighter 
layer  ascends ;  but  it  must  not  be  forgotten  that  its  rise  is  a  passive  process,  and  that  the  really 
active  process  is  the  descent  of  the  overlying  water,  which  is  drawn  down  by  gravity.  By 
coloring  the  bottom  layer  its  ascent  through  the  overlying  layer  may  be  easily  perceived.    If 


28  MEDICAL  CLIMATOLOOY. 

However,  it  will  be  best  for  our  purpose  to  pass  to  a  l^rief  con- 
sideration of  the  local  diurnal  variations  of  winds. 

"  Over  the  oceans  the  velocity  of  the  w^ind  shows  no  distinct  di- 
urnal period;  but  over  the  lands,  and  particularly  in  clear,  warm 
weather,  the  winds  are  distinctly  stronger  about  noon  than  in  the 
night.  There  is  a  slight  diurnal  variation  in  the  mean  direction  of 
the  wind.  The  wind  tends  to  veer  a  little  to  the  right  in  the  north- 
ern hemisphere  as  the  day  passes  and  to  turn  back  again  as  night 
comes  on."^ 

' 'Although  winds  from  some  westerly  point  prevail  at  most  places 
in  our  country  (United  States  of  America),  yet  their  direction  is 
variable.  They  generally  blow^  more  from  the  land  to  the  sea  in 
winter,  and  more  from  the  sea  to  the  land  in  summer.  The  winds 
change  their  direction  and  strength  also  with  every  passing  storm- 
eddy.  Smoke  from  forest  Hres  commonly  spreads  eastward.  Clouds, 
especially  the  higher  ones,  generally  drift  from  some  western  point. 
Thunderstorms  usually  travel  from  west  to  east.  Even  the  great 
eddying  storms  move  eastward.  The  variable  winds  which  we  feel 
are  chiefly  in  the  lower  layers  of  the  air. 

^'  The  winds  of  the  eddying  storms  are  seldom  destructive  on  land. 
They  are  of  great  service  in  bringing  most  of  our  rainfall.  On 
the  sea  and  the  lakes,  however,  they  are  stronger  and  cause  many 
shipwrecks.  The  form  and  movement  of  these  storms  are  well 
shown  on  the  daily  weather-maps  issued  by  the  National  Weather 

the  temperature  be  at  first  uniform  throughout,  it  will  be  noticed  that  the  warmed  water  from 
the  bottom  is  raised  to  the  very  top  of  the  liquid,  maintaining  its  higher  temperature  all  the  way, 
except  for  a  slight  loss  by  conduction  and  mixture  during  ascent ;  while  the  rest  of  the  water 
settles  a  little  distance  toward  the  bottom.  Then  the  new  bottom  layer  repeats  the  process ; 
and  so  a  circulatory  motion  is  established.  This  is  called  a  convectional  circulation,  and  by 
its  means  the  entire  volume  of  water  will  be  warmed  to  almost  as  high  a  temperature  as  is 
maintained  at  the  bottom.  It  depends  essentially  upon  the  disturbance  of  a  condition  of  rest 
by  the  introduction  of  a  change  in  the  temperature  and  a  consequent  change  in  the  density  of 
the  water,  which  is,  therefore,  followed  by  motion  under  the  action  of  gravity.  After  this 
deliberate  explanation  of  the  convectional  process,  its  further  statement  may  be  made  more 
brief  by  speaking  only  of  the  ascent  of  the  warm  under-layer,  with  which  we  are  generally 
most  concerned. 

"Conduction  in  the  atmosphere  may  be  illustrated  by  the  cooling  of  the  lower  air  at  night, 
when  it  loses  heat  chiefly  to  the  colder  surface  of  the  ground  beneath.  This  change  of  tem- 
perature is  not  followed  by  convection,  for  it  leaves  the  heaviest  layer  of  air  at  the  bottom, 
and  does  not  give  gravity  any  opportunity  to  cause  motion.  In  the  daytime,  however,  con- 
duction is  followed  by  convection,  which  then  becomes  an  active  process.  Let  us  consider 
the  case  of  the  air  over  a  dry  plain,  beneath  an  unclouded,  torrid  sun.  The  ground  warms 
rapidly  in  the  morning,  and  soon  becomes  hotter  than  the  air  which  rests  upon  it.  .Conduction, 
aided,  as  at  night,  by  radiation,  increases  the  temperature  of  the  surface-stratum  of  air.  This 
stratum  then  expands,  and  lifts  up  the  overlying  air  by  a  small  amount,  thus  reversing  the 
process  of  the  night  before.  A  peculiar  optic  effect  may  then  be  produced,  called  a  mirage." 
— D.ivis,  Elementary  Meteorology. 

1  Davis  :  Elementary  Meteorology,  p.  132. 


THE  PRINCIPLES  OF  MEDICAL  CLIMATOLOGY.  29 

Bureau.  The  changes  in  weather  which  the  storms  produce  are 
generally  correctly  predicted. 

"As  the  Aviuds  become  cool,  cloudy,  and  wet  when  they  ascend 
mountain-slopes,  so  they  become  warm,  clear,  and  dry  when  they 
descend  the  leeward  slopes.  For  this  reason  a  mild,  dry  wind, 
called  the  chinook,  is  often  felt  in  winter  on  the  plains  along  the 
eastern  base  of  our  northern  Rocky  Mountains.  The  chinook  is  of 
great  service  in  drying  away  the  snow  so  that  the  cattle  can  find 
grass.  "1 

Sea-  and  Land-breezes.  At  the  seashore  there  is  usually  in 
fair  spring  or  summer  weather  a  day -breeze  blowing  toward  the 
shore  and  a  night-breeze  blowing  toward  the  ocean.  The  causes 
of  these  are  that  during  the  day  the  land  is  heated  more  quickly 
than  the  water,  and,  therefore,  the  air  lying  over  it,  being  warm, 
is  pushed  upward  by  the  colder  air  which  flows  in  from  the  ocean 
to  take  its  place.  This  condition  is  reversed  after  sundown. 
Where  great  plains  meet  high  mountain-ranges,  as  in  the  eastern 
foot-hills  of  Colorado,  the  same  phenomena  ensue,  owing  doubtless 
to  the  greater  radiation  of  heat  from  the  mountain-sides  than  from 
the  level  plains.  Perhaps,  also,  the  composition  of  the  mountain- 
sides, being  rocky,  may  increase  the  radiation;  this  would  be  fur- 
thered wherever  the  slopes  are  exposed  to  the  morning  sun,  because 
the  sun  as  it  rises  shines  less  obliquely,  and,  therefore,  with  greater 
power  on  sloping  ground  than  on  level.  Thus  the  air  on  these 
slopes  is  warmed  first  and  rises,  being  displaced  by  a  current  of  air 
from  the  plains.  There  is  a  reasonable  theory  that  the  valleys  in 
the  mountain-slope,  by  concentrating  the  current  of  air,  intensify 
the  draught,  as  does  a  flue;  and  therefore  these  breezes  are  stronger 
on  a  seashore  or  wide  plain  which  is  bordered  by  a  mountain- 
range. 

Mountain-  and  Valley-winds.  In  valleys,  during  the  hours  of 
sunshine,  the  lower  layers  of  air  are  warmed  first,  and  so  rise  along 
the  mountain-sides,  while  toward  night  the  cooler  air  descends  as 
the  evening-wind.  For  this  and  other  reasons  a  hotel  is  often  more 
pleasantly  situated  a  little  way  up  the  mountain  than  at  the  bottom 
of  a  valley. 

The  effects  of  winds  on  climate  are  very  marked,  for  they  are 
the  great  ventilators  and  purifiers  of  the  atmosphere;  winds  carry 

1  Frye's  Complete  Geography. 


30  MEDICAL  CLIMATOLOGY. 

witli  them  from  a  distance  the  temperature,  humidity,  and  impurities 
of  another  place,  and  so  partially  transport  one  climate  to  another. 
Therefore  it  is  necessary  in  selecting  a  resort  to  know  the  character 
and  causes  of  these  foreign  winds  as  well  as  those  of  the  local 
breezes,  and  for  these  reasons  the  shelter  and  aspect  of  the  resort 
should  be  examined.  Wind,  in  proportion  to  its  lack  of  humidity, 
withdraws  moisture  from  the  surface  of  the  soil  and  heat  from  the 
body,  and,  though  it  is  often  beneficially  stimulating,  it  requires  a 
certain  power  of  reaction  in  the  individual  in  order  to  become  so. 

WATER. 

All  water,  apart  from  possible  impurities  and  more  or  less  animal 
life,  contains  some  salts,  the  quantity  varying  from  the  very  large 
proportion  contained  by  the  dense  water  of  the  salt  lakes  to  that 
held  in  rain-water,  which  is  water  naturally  distilled  and  possessing 
a  minimum  amount  of  salts  and  impurities. 

Seas,  lakes,  and  rivers  modify  climate,  increasing  its  humidity 
and  generally  its  rainfall,  and  when  they  are  extensive  they  provide 
the  neighboring  land  with  an  abundance  of  pure  air  which  blows 
from  off  their  surfaces.  As  has  been  shown,  the  difference  in  the 
radiation  of  heat  between  the  land  and  the  water  causes  the  day- 
breezes,  which  are  naturally  stronger  on  the  surface  of  the  water 
than  on  the  shore. 

Rainfall  may  be  great,  while  the  humidity  is  small,  or  vice 
versa.  When  no  cold  breeze  is  blowing  vapor  remains  in  the  air, 
and , the  air  is  damp;  but  if  the  air  becomes  chilled  by  cold  winds 
or  other  causes,  the  vapor  is  condensed  and  is  precipitated  in  the 
form  of  rain  or  snow  or  fog,  and  the  air  is  drier  immediately  after- 
ward. Therefore  a  resort  with  a  light  rainfall  may  yet  have  a  damp 
air.  An  apt  illustration  is  found  in  the  coast  climate  of  Southern 
California,  where,  while  rain  is  infrequent,  the  air  is  usually  moist. 
A  heavy  annual  rainfall  does  not  always  mean  that  there  is  neces- 
sarily a  large  number  of  rainy  days,  as  it  may  rain  heavily  for  only 
a  very  short  time,  and  the  rest  of  the  day  be  clear  and  dry,  or  there 
may  be  a  short  rainy  season  followed  by  a  long  dry  one.  Both  the 
amount  of  rain  and  the  degree  of  humidity  diminish,  as  a  rule,  with 
the  distance  from  the  ocean.  The  general  law  is  that  the  number 
of  rainy  days  and  the  rainfall  increase  in  proportion  to  the  prox- 
imity to  the  equator.     With  the  rise  in  the  height  of  the  land  the 


THE  PRINCIPLES  OF  MEDICAL  CLIMATOLOGY.  31 

precipitation  usually  increases  on  the  European  continent,  while 
on  the  American  continent  the  reverse  is  generally  true.  On 
the  Atlantic  coast  of  North  America  the  rainfall  increases  from 
north  to  south,  and  on  the  Pacific  coast  from  south  to  north. 
Thus  the  normal  precipitation  is  one- half  more  on  the  coast  of 
Florida  than  on  that  of  Maine,  while  the  Southern  California  coast 
has  less  than  one-sixth  the  rainfall  of  the  coast  of  Washington 
State. 

Rain  purifies  the  air  and  increases  the  ozone,  and,  for  the  time  at 
least,  decreases  the  humidity.  Thus  the  effects  of  a  moderate  rain- 
fall, not  so  frequent  or  continuous  as  to  limit  outdoor  life,  are  such 
as  to  revive  and  benefit  the  invalid. 

The  evaporative  power  of  the  air,  which  varies  greatly  accord- 
ing to  the  temperature,  relative  humidity,  density,  and  rate  of 
motion,  modifies  considerably  the  effects  of  rain  in  a  given  locality. 

Clouds  consist  of  small  particles  of  water,  either  liquid  or  ice-\ 
crystals,  floating  in  the  air,  usually  at  considerable  elevations.  In  |\ 
a  general  way  a  cloud  may  be  said  to  be  formed  through  the  cooling 
of  a  saturated  stratum  of  air,  so  that  the  vapor,  being  condensed 
into  minute  drops  or  solid  crystals,  is  rendered  visible.  While 
clouds  are  often  of  service  to  the  invalid  in  lessening  the  heat  and 
glare  of  the  sun  in  summer,  their  prolonged  presence  is  depressing, 
especially  in  winter,  at  which  season  they  usually  increase  the  sense 
of  chilliness  during  the  day.  On  the  other  hand,  by  Hmiting  the 
escape  of  the  heat  radiated  from  the  ground  and  reflecting  it  back, 
they  often  render  warmer  what  would  otherwise  be  a  cool  night, 
and  also  lessen  the  range  of  temperature. 

Fogs  and  mists  are  of  the  same  composition  as  clouds,  but  rest 
on  the  earth's  surface. 

Humidity  is  the  condition  of  the  atmosphere  with  respect  to  the 
water- vapor  which  is  always  present  in  varying  degrees.  When 
this  degree  is  great  the  humidity  is  said  to  be  high;  when  small, 
low.  AVater- vapor  is  formed  by  the  evaporation  from  the  seas  and 
lakes,  which  together  constitute  three-fourths  of  the  earth's  sur- 
face; the  great  change  in  temperature  and  the  breaking  up  of  this 
water-surface  by  land  cause  marked  variations  in  the  humidity  of 
the  air  in  different  localities  and  at  different  times  of  the  day. 
This  vapor  is  derived  from  a  wet  surface  and  slowly  mixes  with  the 
air.  Its  distribution  through  the  atmosphere  is  chiefly  influenced 
by  the  movement  of  the  air,  both  local  and  general.     Thus  wind. 


32  MEDICAL  CLIMATOLOGY. 

when  it  is  not  itself  laden  with  moisture,  tends  to  make  a  resort  less 
damp  than  it  otherwise  would  be. 

'  ^  It  is  commonly  the  case  that  the  air  over  the  land  does  not 
possess  as  much  vapor  as  it  might,  but  on  cool,  damp  nights  the  air 
near  the  ground  is  often  saturated.  This  is  not  because  more  vapor 
is  present  then  than  in  the  daytime,  but  because  of  the  fall  of  tem- 
perature from  day  to  night,  by  which  the  capacity  of  the  air  is 
reduced  so  far  that  the  amount  of  vapor  already  present  saturates 
the  air.  On  the  ocean,  particularly  in  the  calms  of  the  doldrums, 
the  air  is  nearly  saturated  all  the  year  round.  This  is  because  the 
inflowing  trades,  blowing  over  the  warm  surface  of  the  ocean  and 
warming  slowly  as  they  advance  from  either  side,  are  continually 
supplied  with  vapor,  so  as  to  maintain  them  in  an  almost  saturated 
condition.  While  loitering  in  the  doldrums  their  vapor  is  even 
more  increased.  Even  the  slight  cooling  of  the  air  over  the  equatorial 
ocean  at  night  is,  therefore,  sufficient  to  make  it  excessively  damp. 

"  On  the  other  hand,  in  desert  regions  the  supply  of  moisture  is 
so  small  that  the  quantity  of  vapor  present  is  far  from  satisfying 
the  capacity  of  the  air.  There  is  very  little  moisture  present  com- 
pared to  that  which  might  exist;  the  air  is  then  relatively  dry.  The 
same  condition  occurs  frequently  in  our  cold  northwest  winds  of 
winter.  These  come  from  a  northern  interior  region,  where  their 
temperature  is  very  low,  and  where  but  little  moisture  is  present. 
They  then  advance  rapidly  into  milder  latitudes,  warming  as  they 
come,  but  proceeding  so  quickly  that  their  increasing  capacity  for 
vapor  is  not  satisfied.  They  frequently  do  not  contain  half  as  much 
vapor  as  they  might,  and  sometimes  this  fraction  falls  as  low  as  a 
third.  The  upper  regions  of  the  atmosphere  are  also  found  to  be 
prevailingly  dry.  This  seems  to  be  the  case  even  over  the  ocean, 
and  must  be  regarded  as  the  result  of  the  remoteness  of  the  great 
volume  of  the  atmosphere  from  the  ocean  surface,  and  of  the 
obstruction  that  the  air  presents  to  the  upward  diffusion  of  vapor. 

^'  The  humidity  of  the  atmosphere  exercises  a  strong  control  over 
our  bodily  sensation  of  the  temperature  of  the  air.  The  body  does 
not  act  like  a  thermometer,  readily  accepting  the  temperature  of 
the  surrounding  medium,  but  attempts  to  maintain  an  internal  tem- 
perature of  about  98^,  known  as  '  blood-heat,'  at  all  seasons.  We 
prevent  an  uncomfortable  reduction  of  temperature  in  cold  air  by 
sheltering  the  body  from  loss  of  heat  by  a  covering  of  clothing ;  if 
the  air  is  windy,  more  protection  is  needed  than  when  it  is  calm; 


THE  PRINCIPLES  OF  MEDICAL  CLIMATOLOGY.  33 

if  it  is  damp  as  well  as  cold  and  windy,  it  abstracts  all  the  more 
heat  from  us,  probably  by  means  of  the  better  conductivity  given 
both  to  the  air  and  to  the  clothing  by  the  moisture;  hence  the  differ- 
ence between  the  bracing  though  severe  cold  of  our  dry  northwest 
winter-winds  and  the  penetrating,  searching  chill  of  our  damj) 
winter  northeasters.  The  difference  between  the  so-called  '  dry  cold ' 
of  the  interior  and  the  '  damp  cold '  of  the  New  England  coast  is 
thus  explained.  On  the  other  hand,  when  the  air  is  warm  our 
bodily  temperature  would  rise  too  high  if  it  were  not  for  the  cooling 
of  the  skin  by  the  continual  evaporation  from  its  surface.  In  very 
hot  and  very  dry  air  the  evaporation  is  so  much  hastened  that  the 
skin  is  parched  and  burned;  in  hot  and  very  damp  air  evaporation 
is  checked  and  the  air  feels  sultry  and  oppressive.  Moderately  dry, 
hot  air  is  less  uncomfortable  than  at  either  of  the  extremes  of  dry- 
ness or  dampness.  The  oppressiveness  of  our  '  dog-day  '  weather  in 
July  and  August  depends  as  much  upon  its  humidity  as  on  its  heat."^ 

Absolute  humidity  is  the  actual  number  of  grains  of  vapor  in 
a  given  quantity  of  air,  usually  estimated  by  the  weight  of  vapor 
in  each  saturated  cubic  foot  of  air.  As  air  expands  with  a  rise  of 
temperature  its  capacity  for  holding  vapor  increases  rapidly.  Thus 
when  the  temperature  is  at  zero  each  cubic  foot  of  air  can  hold  only 
0.54  grain,  this  being  its  point  of  complete  saturation.  At  32°  F., 
however,  it  can  hold  2.13  grains;  at  50°  F.,  4.09  grains;  at  80° 
F.,  10.95  grains;  and  at  100°  F.,  19.79  grains. 

Relative  humidity  is  the  percentage  of  vapor  actually  contained 
in  a  given  quantity  of  air  as  compared  with  its  capacity;  its  value 
as  a  test  of  dampness  is,  of  course,  entirely  dependent  upon  the 
temperature,  and  cannot  be  considered  without  it.  An  amount  of 
vapor  sufficient  to  cause  a  high  relative  humidity  at  a  low  tempera- 
ture would  cause  only  a  low  relative  humidity  at  a  high  one.  For 
example,  if  the  relative  humidity  of  the  air  stood  at  60  per  cent, 
while  the  temperature  was  40°  F.,  it  would,  in  the  same  air,  drop 
down  to  only  10  per  cent,  if  the  temperature  was  raised  to  80°  F. 

Dry  and  Moist  Climates.  In  classifying  climates  as  dry  and 
moist  it  is  important  to  notice  whether  absolute  or  relative  humidity 
is  intended,  and  this  must  often  be  inferred  from  the  connection  in 
which  the  words  are  employed.  Relative  humidity  is  important  in 
respect  to  the  liability  of  the  formation  of  fogs  and  dew,  while  phys- 

1  Davis :  Elementary  Meteorology,  p.  144. 


34  MEDICAL  CLIMATOLOGY. 

iologically  the  absolute  humidity  has  often  a  greater  significance. 
When  statistics  of  relative  humidity  alone  are  given  it  is  necessary  to 
take  some  standard  temperature  to  make  a  fair  comparison.  AVendt 
computes  the  mean  annual  temperature  of  the  United  States  as  55° 
F.,  which  is  probably  nearly  correct.  Assuming,  then,  a  standard 
temperature  of  55°  F.,  we  can  say  that  less  than  50  per  cent,  of 
relative  humidity  is  dry;  from  65  to  75  per  cent,  is  medium  ;  from 
75  to  85  per  cent,  is  moist;  and  above  85  per  cent,  very  moist. 

The  importance  of  the  temperature  should  never  be  forgotten 
in  estimating  the  value  of  the  relative  humidity.  For  instance,  on 
an  ordinary  sunny  day  in  winter  with  the  shade-temperature  at  noon 
at  40°,  we  should  consider  under  70  per  cent,  of  relative  humidity 
as  very  dry  ;  from  70  to  80  per  cent.,  dry  ;  from  80  to  90  per  cent., 
moist;  and  above  90  per  cent.,  very  moist.  On  the  other  hand,  on  a 
day  in  summer  when  the  shade-temperature  at  noon  is  70°  F.,  we 
find  less  than  30  per  cent,  of  relative  humidity  at  that  temperature 
is  very  dry  ;  from  30  to  40  per  cent,  is  dry ;  from  40  to  50  per  cent, 
is  medium  ;  from  50  to  70  per  cent,  is  moist ;  and  over  70  per  cent, 
is  very  moist. 

Dew-point  is  the  temperature  at  which  the  atmosphere  deposits 
dew.  As  has  been  stated  in  the  paragraph  upon  absolute  humidity, 
the  capacity  of  the  air  for  holding  water-vapor  is  increased  by  a  high 
temperature  and  diminished  by  a  low  one.  For  this  reason  dew  is 
formed  usually  in  the  night,  when  the  air  is  cooled,  and  it  is  absent 
during  the  hours  of  sunshine,  when  the  air  is  warm.  As  dew  can 
only  form  by  the  cooling  of  air  which  is  charged  with  vapor  to  the 
point  of  saturation,  the  damper  the  air  the  sooner  the  dew-point  is 
reached,  so  that  in  a  damp  climate  the  dew-point  is  high  and  in  a 
dry  one  low. 

The  dryness  o\  a  resort  may  be  judged  not  only  by  the  relative 
and  absolute  humidity,  but  also  by  the  dew-point  when  taken  in 
connection  with  the  mean  temperature,  because  when  the  mean  dew- 
point  and  the  mean  temperature  are  near  together  dews,  fogs,  and 
mists  are  sure  to  be  frequent,  and  when  they  are  far  apart  such  man- 
ifestations of  humidity  must  be  of  rare  occurrence. 

In  speaking  of  dew  as  being  formed  from  the  water-vapor  of 
the  atmosphere,  it  must  also  be  remembered  that  vapor  will  arise 
from  the  soil,  drawn  up  by  capillary  attraction  from  the  subsoil;  if 
the  dew-point  of  the  air  is  high,  the  air  soon  becomes  saturated  and 
the  moisture  drawn  from  the  soil  forms  an  additional  deposit  of  dew. 


THE  PRINCIPLES  OF  MEDICAL  CLIMATOLOGY.  35 

Vegetation  also  gives  off  into  tlie  cooling  air  the  water  that  it 
draws  from  the  soil,  or  has  previously  received  from  the  atmosphere, 
and  so  further  contributes  to  the  dew-formation.  Thus  dryness  of 
the  soil  and  scarcity  of  vegetation  lessen  the  frequency  of  dew. 
So  we  see  that  a  low  dew-point  and  a  low  relative  humidity  are 
an  evidence  of  the  rarity  of  dew,  mist,  and  fog. 

As  evaporation  is  increased  by  heat,  dryness,  and  wind,  it  is 
greater  in  summer  than  in  winter,  in  sunshine  than  in  shade,  in 
wind  than  in  calm,  at  noon  than  at  night.  This  readiness  of  the 
air  to  absorb  moisture  keeps  it  continually  s)ipplied  with  the  vapor 
which  is  necessary  to  all  living  matter.  The  water- vapor  thus 
drawn  up  and  diffused  in  the  air  exerts  a  most  powerful  influence 
over  climate:  first,  because  by  its  absorption  of  heat  it  lessens  the 
radiation  of  heat  from  the  earth's  surface;  and,  secondly,  because 
when  condensed,  as  in  clouds,  it  prevents  the  free  passage  of  the 
sun's  rays,  and  thus  regulates  light  and  heat.  The  activity  of 
electricity  and  the  amount  of  ozone  are  controlled  by  it,  while  rain, 
dew,  fog,  and  snow  are  formed  from  it. 

Consequently,  in  dry  climates  and  during  dry  seasons,  there  being 
little  vapor  to  hold  the  heat  in  the  air  and  few  clouds  to  prevent  its 
radiation  into  space,  the  sun's  rays  are  but  slightly  obstructed;  the 
sunshine  is  hotter,  the  shade  cooler,  and  the  extremes  between  day 
and  night  more  marked  than  in  damp  climates  and  during  damp 
seasons.  On  the  other  hand,  in  damp  climates  the  power  and  bril- 
liancy of  the  sun's  rays  are  lessened,  and  the  moist  air,  while  sooth- 
ing, is  apt  to  be  enervating,  especially  when  warm;  excessive  rain 
is  still  more  so,  and  is  more  objectionable  because  it  interferes  with 
outdoor  life. 

SUN. 

Light.  The  direct  effects  of  light,  apart  from  heat,  are  difficult  to 
demonstrate,  but  it  has  been  proved  that  it  checks  the  growth  of 
bacteria  and  low  organisms,  while  it  increases  oxidation.  Weber  and 
others  have  observed  that  a  want  of  sunlight  will  develop  symp- 
toms of  general  depression  and  a  condition  analogous  to  intermit- 
tent fever.  Sunlight  is  more  intense  in  dry  than  in  damp  climates, 
and  lasts  longer  in  summer  in  high  latitudes,  while  during  winter 
the  reverse  holds  good.  This  question  of  the  number  of  hours  of 
sunshine  is  very  important  in  estimating  the  value  of  health-resorts 
situated  in  mountain-valleys. 


36  MEDICAL  CLIMATOLOGY. 

Heat  and  its  General  Causes.  The  cause  of  the  warmth  of 
the  atmosphere  and  the  earth's  surface  is  the  sun,  which  raises  the 
temperature: 

1.  By  its  direct  heat  or  radiation. 

2.  By  return-radiation  from  the  earth. 

3.  By  conduction  from  the  earth. 

4.  By  atmospheric  currents. 

1.  Direct  radiation  gives  but  little  warmth  to  the  air,  since  pure, 
dry  air  is  diathermanous  to  the  sun's  rays,  and  it  is  only  by  means 
of  the  aqueous  vapor-clouds  and  dust  that  the  rays  part  with  any 
heat  on  the  way,  so  that  the  damper  the  air  and  the  more  dust- 
particles  it  contains  the  more  easily  is  it  heated  by  the  sun. 

2.  Indirect  return-radiation,  w4iich  is  chiefly  reflection  from  the 
earth's  surface,  is  influenced  by  the  nature  of  the  solid  and  liquid 
surfaces  and  also  by  their  color;  the  nearer  white  it  is,  the  more  the 
sun-heat  is  reflected  back;  most  of  the  heat  is  reflected  back  at  once, 
the  rest  is  retained  for  a  longer  or  shorter  time  on  the  ground;  then 
all,  or  at  least  a  greater  part,  is  radiated  back  into  the  atmosphere. 
For  this  reason  the  character  of  the  soil  in  a  health-resort  should 
be  taken  into  consideration,  sand  and  gravel  being  best. 

3.  The  earth  gives  up  a  portion  of  the  w'armth  which  it  has  taken 
up,  to  the  layer  of  air  which  is  in  immediate  contact  with  it;  this 
is  pushed  up  and  replaced  by  a  heavier  and  cooler  layer,  which  in  its 
turn  rises  and  gives  place  to  another,  and  so  on,  and  thus  a  large 
amount  of  air  is  warmed. 

4.  Winds  are  the  most  important  form  of  movement  in  the  aerial 
ocean;  by  them  atmospheric  changes  originating  in  one  place  are 
carried  to  distant  localities.  The  heating  of  a  layer  of  air  by  conduc- 
tion and  radiation  causes  it  to  become  lighter,  and  the  surrounding- 
cold  air,  pushing  it  upward,  takes  its  place,  giving  rise  to  a  current 
which,  when  marked,  is  called  a  wind.  By  such  currents  heated 
air  is  carried  from  the  equator  tow'ard  the  poles. 

Cold.  As  an  opposing  influence  to  the  heatiug  process  first 
named  there  are  constant  cooling'-influences  at  work: 

1.  Continual  radiation  of  heat  into  space. 

2.  A  fluctuating  amount  of  heat  rendered  latent  by  evaporation 
from  the  ground,  w^aters,  and  plants. 

3.  When  the  earth,  as  it  always  does,  has  radiated  heat  more 
quickly  than  the  air,  it  becomes  cooler  than  the  atmosphere,  which 
then  gives  up  heat  by  radiation  as  well  as  by  direct  conduction. 


THE  PRINCIPLES  OF  MEDIC  A  L  CLIMA  TOL  00  Y.  37 

Local  causes  of  heat  often  raise  the  temperature  of  a  locality 
above  that  which  is  normal  to  its  latitude  (i.  e.,  distance  from  the 
equator).  These  causes  are  many,  and  we  may  instance  the  follow- 
ing :  the  neighborhood  of  Avarm- water  currents,  as  the  Gulf-stream; 
warm-air  currents  blowing  from  off  warm  seas  or  deserts;  or  the 
shelter  afforded  by  mountains  from  cold  winds. 

Local  Causes  of  Cold.  On  the  other  hand,  elevation  above  sea- 
level;  the  intervention  of  wide  seas  between  the  locality  and  the 
equator,  or  their  absence  toward  the  poles;  the  existence  of  cold 
currents;  mountain-ranges  which  divert  warm  winds;  the  frequency 
of  clouds  in  summer  and  their  absence  in  winter,  and  like  causes, 
frequently  make  a  climate  colder  tlian  is  normal  to  its  degree  of 
latitude. 

The  mean  annual  temperature  is  often  the  same  in  widely  dif- 
fering climates,  and  is,  therefore,  of  little  importance  therapeu- 
tically; while  the  temperature  of  the  various  seasons,  and  of  day 
and  night,  also  the  frequency  of  changes  of  temperature  from  day 
to  day,  are  of  the  greatest  consequence  as  affecting  the  amount  of 
time  and  frequency  of  opportunity  for  outdoor  life. 

ELECTRICITY. 

The  electricity  of  the  earth  is  negative  and  that  of  the  atmosphere 
positive.  Electric  disturbances  are  most  common  between  3500  and 
6500  feet  above  sea-level.  The  positive  electricity  of  the  atmosphere 
is  increased  at  altitudes  and  when  the  sky  is  clear,  which  may  partly 
explain  the  exhilaration  experienced  by  visitors  to  medium  eleva- 
tions. During  fogs  the  atmospheric  electricity  is  highly  positive, 
according  to  Schiibler,  while  negative  electricity,  on  the  rare  occa- 
sions when  it  has  been  found  at  all,  has  been  present  in  the  air 
during  heavy  showers  of  rain. 

"  The  electricity  of  the  atmosphere  is  stronger  in  winter  than  in 
summer,  and  is  strongest  in  January,  decreasing  from  this  month 
to  June,  and  then  increasing  again  to  January.  Like  moisture  and 
warmth,  Avith  which  it  is  closely  connected,  it  is  subject  to  diurnal 
periodical  variations — that  is,  to  a  double  maximum  and  minimum 
(Saussure  and  Schiibler).  It  rises  from  daybreak  to  the  first  max- 
imum between  6  and  8  a.m.  in  summer,  and  at  about  10  a.m.  in 
winter;  it  then  falls  to  the  first  minimum  between  4  and  (3  p.m.  in 
summer,  and  at  about  3  p.m.  in  winter;  it  rises  to  a  second  maxi- 


38  MEDICAL  CLIMATOLOGY. 

mum  one  and  one-half  to  two  honrs  after  sunset,  and  then  decreases 
to  a  second  minimum,  which  is  reached  about  daybreak.  The 
sources  of  electricity  are  said  to  be  evaporation,  vegetation,  oxida- 
tion and  other  chemical  processes,  and  friction.  According  to  Pel- 
tier and  Lamont,  however,  the  negative  electricity  of  the  earth's 
surface  seems  to  be  the  chief  agent  in  the  production  of  the  elec- 
tricity of  the  atmosphere  when  it  contains  aqueous  vapor.'" 

While  it  is  probable  that  the  effects  of  atmospheric  electricity 
upon  both  healthy  and  diseased  persons  are  very  decided  and  im- 
portant, yet  our  knowledge  is,  at  present,  too  limited  to  enable  us  to 
form  definite  conclusions  regarding  them. 

1  Ziemssen's  System  of  Therapeutics,  vol.  iv.  p.  56. 


CHAPTER   II. 

PHYSIOLOGY. 

Heat  promotes  growth,  though  a  smaller  amount  of  food  is  con- 
sumed or  required,  but  it  lessens  muscular  power;  when  humidity 
is  present  these  effects  are  intensified. 

Cold.  In  a  cold  atmosphere  carbonic  acid  is  more  freely  given 
off  and  there  is  greater  waste  of  substance.  Cold  limits  growth, 
but  tends  to  preserve  what  may  have  been  gained  and  to  increase 
muscular  power.  If,  however,  a  cold  climate  be  also  humid,  these 
effects  are  not  so  marked.  Cold  is  more  healthful  than  heat,  as  shown 
by  the  fact  that  the  rate  of  mortality  lessens  with  distance  from  the 
equator. 

Humidity.  Absolute  humidity — that  is,  the  actual  amount  of 
vapor  in  a  given  quantity  of  air — is  of  importance  in  breathing,  as 
the  amount  of  water-vapor  exhaled  with  each  breath  is  much  greater 
when  the  air  is  dry  than  when  it  is  damp.  Further,  as  there  is 
always  more  vapor  in  warm  than  in  cold  air,  not  only  is  more  water 
evaporated  from  the  lungs  in  dry  than  in  damp  air,  but  also  in 
cold  than  in  warm  air;  thus  both  absolute  and  relative  humidity 
modify  the  air  we  breathe  and  influence  the  processes  of  respiration. 
As  a  result,  cold,  dry  air  lessens  secretion  from  ulcerated  lung  or 
bronchial  tissue.  It  also  reduces  the  body-temperature  by  the  in- 
creased evaporation. 

Perspiration.  In  consequence  of  the  same  laws  it  must  follow 
that  there  is  an  increased  secretion  from  the  skin  in  dry  air ;  but 
the  evidence  of  perspiration  is  less  noticeable  because  it  is  immedi- 
ately converted  into  vapor  by  the  dry  air,  instead  of  condensing  upon 
the  surface  of  the  skin  in  drops  of  sweat.  Thus,  in  a  warm,  dry 
air  much  of  the  perspiration  is  insensible ;  while  in  a  warm,  damp 
air  it  is  readily  perceived.  Thus  through  the  increased  evaporation, 
and  its  cooling  effect  upon  the  body,  the  fact  is  accounted  for  that  a 
higher  temperature  can  be  borne  with  less  discomfort  in  a  dry  than 
in  a  moist  air,  as  is  shown  in  the  Turkish  or  hot  dry-air  bath  and 
the  Russian  or  hot- vapor  bath. 

Cold  as  well  as  heat  is  more  endurable  when  the   air  is  dry. 


40  MEDICAL  CLIMATOLOGY. 

Evaporation  from  the  skin  occurs  also  in  cold,  dry  air,  but  to  a 
limited  extent  only,  and  the  consequent  loss  of  heat  can  be  largely 
obviated  by  clothing,  provided  a  high  wind  be  not  blowing.  There 
is  also  very  little  loss  of  heat  by  conduction  in  cold,  dry  air  and  a 
very  great  loss  in  cold,  damp  air ;  when  the  wind  is  also  blowing 
this  loss  of  heat  is  far  greater  than  in  cold,  dry  air. 

Increased  barometric  pressure  up  to  an  addition  of  a  half  to 
two  atmospheres  has  been  shown  by  experiment  to  lessen  the  pulse- 
rate,  although  it  increases  its  strength  and  volume.  The  number 
of  respirations  is  diminished,  while  their  depth  is  increased.  A 
larger  amount  of  oxygen  is  absorbed,  and  consequently  more  car- 
bonic acid  is  exhaled.  The  desire  for  food  is  increased  and  also  the 
ability  to  assimilate  it.  When  the  pressure  of  two  or  three  addi- 
tional atmospheres  is  suddenly  removed,  as  has  been  the  case  with 
workmen  returning  from  labor  in  caissons  and  deep  mines,  the 
following  effects  have  been  observed  :  vertigo,  nausea,  pains  in  the 
joints  and  ears,  even  paresis,  which  in  most  cases  was  temporary,  but 
in  some  fatal.  In  one  of  these  an  autopsy  showed  peculiar  lesions 
of  the  spinal  cord,  which  appeared  as  if  grooved  and  torn. 

When  atmospheric  air  is  compressed  the  oxygen-tension  is  in- 
creased. In  experiments  upon  animals  placed  in  chambers  contain- 
ing compressed  air  it  was  found  that  there  was  a  slight  lessening 
of  the  rate  of  respiration,  and,  if  the  pressure  was  very  high,  convul- 
sions arose  and  death  ensued  from  asphyxia.  This  was  due  to 
retention  in  the  blood  of  carbon  dioxide,  which  could  not  escape 
owing  to  the  great  air-pressure,  although  there  was  a  superabun- 
dance of  oxygen  to  be  absorbed.  As  might  be  expected,  the  effects 
of  compressed  air  are  exactly  contrary  to  the  effect  of  reduced  baro- 
metric pressure  as  exhibited  under  bell-glasses  or  in  high  altitudes. 
These  experiments  did  not  cause  any  of  the  peculiar  nervous  effects 
arising  in  some  persons  after  leaving  caissons  in  which  they  had 
been  working  ;  which  symptoms  are  chiefly  due  to  congestion  and 
frequently  to  degeneration  of  the  lower  half  of  the  spinal  cord. 
Autopsies  have  revealed  congested  areas  with  spots  of  degenera- 
tion, even  rents  in  the  tissue,  escaping  bubbles  of  gas  (asserted  by 
Paul  Bert  to  be  nitrogen),  black  blood,  etc.  During  life  various 
paralyses  were  observed.  It  is  probable,  as  stated  by  Andrew  Smith 
and  also  by  Oilman  Thompson,^  that  the  cause  of  these  nervous 

1  Medical  Record,  February  3, 189-1. 


PHYSIOLOGY.  41 

phenomena  is  the  exhausting  nature  of  the  work  in  the  caissons, 
followed  by  too  sudden  a  change  back  into  ordinary  air. 

Upon  the  effects  of  compressed  air  Dr.  Theodore  Williams  writes 
as  follows  : 

"  Some  years  ago  I  placed  two  remarkably  healthy  house-physi- 
cians of  the  Brompton  Hospital  in  the  compressed  air-bath,  where 
they  remained  three  hours  and  a  quarter,  and  most  of  my  conclu- 
sions as  to  the  effect  of  compressed  air  on  normal  subjects  are  the 
results  of  observations  carefully  taken  by  these  gentlemen  on  each 
other  and  afterward  checked  by  myself.  The  effect  on  respiration 
of  the  compressed-air  bath  is  that  the  individual  finds  that  he 
breathes  slower,  deeper,  and  more  easily.  The  respiration-rate, 
according  to  my  observations,  falls  from  16  or  20  to  14  or  15  at 
least.  Von  Vivenot  foimd  it  fall  to  4  or  even  3  a  minute.  Inspi- 
ration becomes  very  easy,  but  expiration  is  less  easy ;  the  ratio 
between  them  undergoes  cousiderable  modification,  expiration  being 
sometimes  twice  or  three  times  as  long  as  inspiration.  The  increased 
depth  of  the  inspiration  is  shown  by  Lowne's  spirometer,  which  in- 
variably gives  an  increase  in  the  amount  of  air  expired.  It  would 
appear  that  breathing  compressed  air  increases  lung-capacity,  prob- 
ably by  opening  up  more  alveoli,  which  had  previously  not  been 
brought  into  use,  aud  we  must  suppose  that  the  diminished  number 
of  respirations  means  that  their  amplitude  makes  up  for  their  smaller 
number.  The  effect  on  the  circulation  is  that  the  j)ulse  is  slower, 
smaller  in  volume,  but  of  increased  arterial  tension;  the  capillaries 
smaller,  and  the  veins  less  full  of  blood.  The  pulse-rate  diminishes 
4  10  20  beats  a  minute,  but  on  returning  to  the  outer  air  it  returns 
at  once  to  the  normal.  Sphygmographic  tracings  show  a  lowering 
in  the  height  of  the  tidal  aud  dicrotic  waves. 

'^  The  effect  of  the  pressure  on  the  circulation  was  admirably 
shown  by  Von  Vivenot's  observations  on  a  white  rabbit  in  the  bath. 
Under  normal  pressure,  with  the  rabbit  quiet  and  at  liberty,  the 
ears  were  fall  of  blood,  the  conjunctival  vessels  injected,  and  the 
iris  tinted  deep  red  ;  but  in  a  compressed-air  bath  the  vessels  of  the 
conjunctiva  became  finer  and  more  pale,  and  in  one  experiment  they 
alternately  filled  and  emptied.  When  pressure  was  maintained  at 
the  maximum  the  iris  and  pupil  became  decolorized,  aud  the  ears, 
seen  by  transmitted  light,  showed  empty  vessels,  and  the  larger 
vessels  were  scarcely  visible. 

^^  From  these  latter  observations  the  conclusion  is  that  compressed 


42  MEDICAL  CLIMATOLOGY. 

air  exercises  an  intropulsive  influence  on  the  circulation,  affecting 
those  surfaces  most  exposed  to  it,  such  as  the  skin  and  lungs.  The 
blood  is  thus  drawn  into  the  organs  protected  from  air-pressure, 
namely,  the  brain,  heart,  liver,  kidneys,  and  spleen.  The  pressure 
is  exerted  more  on  the  capillaries  and  superficial  veins  than  on  the 
deeper  veins  and  arteries,  and  its  tendency  would  be  to  reduce  pres- 
sure iu  the  right  side  of  the  heart  and  to  increase  it  on  the  left. 
Dr.  Burdon  Sanderson  thus  accounts  for  the  slower  pulse-rate  :  '  The 
effect  of  the  diminished  fulness  of  the  venous  system  is  to  retard  the 
filling  of  the  ventricles  during  the  period  of  relaxation,  and  conse- 
quently to  lengthen  the  diastolic  period  and  thus  diminish  the  fre- 
quency of  the  pulse.' 

"  The  introduction  of  a  larger  amount  of  oxygen  causes  greater 
absorption  by  the  lungs  and  leads  to  further  oxidation  and  tissue- 
change  ;  this  being  proved  by  the  bright  color  of  the  blood  seen 
duriug  bleedings  in  the  bath,  by  the  increase  of  carbonic  acid  exhaled 
from  the  lungs  and  of  urea  excreted  by  the  kidneys.  Muscular 
power  is  augmented,  appetite  generally  improves,  and  weight  is 
almost  invariably  gained.  The  temperature  is  not  materially 
affected.  "1 

Depressed  climates,  which  are  examples  of  naturally  increased 
barometric  pressure,  are  found  in  places  on  the  earth's  surface 
which  are  below  sea-level.  As  no  complete  or  satisfactory  scientific 
observations  have  been  made  with  regard  to  the  peculiar  physiological 
effects  of  increased  pressure,  they  cannot  be  here  discussed  ;  but  cer- 
tain of  the  resorts  are  described  and  the  clinical  experience  given 
in  a  later  chapter. 

Decreased  barometric  pressure  is  best  discussed  in  its  physio- 
logical effects  under  elevated  climates.  At  high  altitudes  the  special 
effects  of  decreased  pressure  are  not  directly  produced  by  the  scarcity 
of  oxygen  in  the  atmosphere,  but  by  the  diminished  oxygen- 
pressure  ;  for  even  at  the  greatest  heights  ever  reached  by  man  the 
amount  of  oxygen  in  each  breath  is  always  in  excess  of  that  needed 
to  sustain  animal  life.  It  has  been  demonstrated  by  experiment 
that  blood  can  absorb  only  a  certain  percentage  of  the  total  amount 
of  oxygen  present  in  the  air  to  which  it  is  exposed,  and  so,  when 
the  barometric  pressure  is  reduced,  the  blood  may  be  unable  to  ex- 
tract sufficient  oxygen  from  the  air  because  the  oxygen-pressure  is 
reduced  below  the  required  point. 

1  Williams's  Aeiotherapeutics,  p.  102. 


PHYSIOLOGY.  43 

Mountain-siekness  is  a  malady  caused  by  this  oxygen-starva- 
tion. If  this  were  all,  it  would  follow  that  when  the  oxygen- 
pressure  was  sufficiently  reduced  animal  life  would  be  impossible 
from  continual  mountain-sickness;  but  there  is  developed  a  wonder- 
ful compensatory  process  whereby  the  blood's  power  of  absorbing 
oxygen  is  increased,  so  that  a  given  weight  of  blood  in  a  living 
animal  can  absorb  more  oxygen  in  proportion  to  the  reduction  of 
the  barometric  pressure.  This  is  brought  about  by  a  growth  in  the 
number  of  red  corpuscles  in  the  blood  and  of  the  hnsmoglobin  which 
is  contained  in  them.  The  haemoglobin  is  that  portion  of  the  blood 
contained  in  the  red  corpuscles  through  which  oxygen  is  absorbed. 

While  these  blood-changes,  which  need  some  three  or  four  weeks 
for  their  completion,  are  progressing,  the  breathing  becomes  more 
rapid,  so  that  while  less  oxygen  is  taken  in  at  each  breath,  it  is 
received  into  the  blood  more  frequently ;  and  with  this  more  rapid 
respiration  there  is  increased  heart-action,  the  heart  pumping  more 
blood  through  the  lungs  in  a  given  space  of  time. 

This  increased  rapidity  of  heart-beat  and  respiration  is,  however^ 
only  temporary,  and  gradually  disappears.  The  amount  of  air 
taken  in  at  each  breath  becomes  greater  as  the  chest  expands  and 
the  air-cells,  many  of  which  are,  at  lower  altitudes,  often  unused^ 
are  dilated.  The  heart's  cavities,  having  been  stretched,  are  also 
dilated,  so  that  more  blood  is  propelled  at  each  stroke.  Thus  the 
blood's  capacity  for  absorbing  oxygen,  the  lung's  capacity  for  taking 
air,  and  the  heart's  capacity  for  pumping  blood  are  increased ;  the 
rapidity  of  respiration  and  pulse  diminishes,  but  they  become  normal 
again  in  rate  as  soon  as  this  process  of  compensation  has  effected  a 
balance. 

These  changes  in  the  blood,  lungs,  and  heart  continue  during  a 
residence  at  high  altitudes,  but  disappear  again  upon  a  return  to 
low  ground.  However,  they  are  occasionally  so  incompletely  car- 
ried out  in  certain  individuals,  owing  to  age,  feebleness  of  reaction, 
or  disease,  that  attempted  ascent  into  the  upper  air  is  exceedingly 
dangerous  and  continued  residence  on  high  ground  impossible.^ 

BaUoon-asoents.  Rapid  diminution  of  barometric  pressure,  as  in 
balloon-ascents,  is  much  more  trying  than  the  more  gradual  change 
consequent  upon  the  ascent  of  a  mountain.  The  phenomena  of 
mountain-sickness   may   appear  at   lower  elevations   in  those  who 

1  On  this  subject  see  Twentieth  Century  Practice,  vol.  iii.  p.  216. 


44  MEDICAL  CLIMATOLOGY. 

climb  than  in  those  who  are  carried  in  balloons  or  chairs,  on 
account  of  the  fatigue  attendant  upon  the  exertion.  If  the  aero- 
naut remains  for  a  short  time  at  a  moderate  elevation,  the  symp- 
toms in  his  case  may  not  be  so  severe ;  but  the  results  of  ascending 
rapidly  to  a  great  height  are  often  alarming  and  may  be  fatal,  as  in 
the  case  referred  to  by  Whymper,  as  follows  :  "  On  April  15,  1875, 
Messrs.  Croce-Spinelli  and  Sivel  left  the  earth  at  11.35  a.m.,  and 
in  two  hours  more  hovered  about  26,000  to  28,000  feet.  At  the 
end  of  this  time  both  were  found  suffocated,  with  their  mouths  full 
of  blood  ;  but  neither  the  time  nor  the  elevation  at  which  they  died 
is  known  exactly,  as  M,  Tissandier,  the  sole  survivor  of  the  party, 
was  rendered  insensible  and  was  thus  unable  to  give  a  complete 
account  of  the  affair." 

The  cause  of  this  disaster  was  undoubtedly  the  same  as  that  which 
gives  rise  to  mountain-sickness  in  mountain-climbers,  namely,  the 
diminished  barometric  pressure ;  but  in  a  gradual  ascent  this  cause 
operates  simply  through  diminished  oxygen-pressure,  while  with 
the  rapidly  ascending  aeronaut  not  only  does  diminished  oxygen- 
pressure  distress  him,  but  also  the  sudden  change  of  atmospheric 
pressure,  which  causes  for  a  time  an  inequality  in  the  mechanical 
pressure  of  the  atmosphere  upon  the  outside  and  the  inside  of  his 
body.  The  mechanical  effect  of  sudden  change  in  the  density  of 
the  air  surrounding  an  individual  is  also  exhibited  in  caisson-disease. 

It  may  be  said,  then,  that  in  mountain-ascents  the  cause  of  moun- 
tain-sickness, leaving  out  the  effects  of  exertion,  is  simply  diminished 
oxygen-pressure,  while  in  balloon-ascents  it  is  thisp^fts  rapidly  dimin- 
ished atmospheric  pressure.  The  inhalation  of  oxygen  has  been 
resorted  to  by  aeronauts  when  at  great  elevations,  with  marked  relief 
to  their  unpleasant  symptoms. 

The  greatest  height  known  was  reached  by  Coxwell  and  Glaisher 
in  a  balloon  on  September  5,  1862;  they  lost  consciousness  at  an 
elevation  of  27,000  feet,  and,  continuing  rapidly  to  ascend,  reached 
a  much  greater  but  unknown  height,  not  recovering  until  they  had 
asain  descended  to  27,000  feet. 

Mountain-climbing'.  Healthy  persons,  ascending  to  elevations, 
experience  a  more  or  less  pleasant  stimulation  of  body  and  mind  ; 
but  while  the  impulse  to  exercise  is  increased,  the  ability  to  do  so  is 
diminished  with  the  altitude,  though  in  the  strong  tolerance  is  soon 
established,  and  feats  exhibiting  great  powers  of  endurance  have 
been  accomplished  by  mountain-climbers.  In  the  feeble  or  diseased, 
or  when  considerable  heights  have  been  reached,  irregularities  of 


PHYSIOLOGY.  45 

breathing  and  heart-beat  are  experienced,  and  symptoms,  due  doubt- 
less to  autemia  of  the  brain,  such  as  giddiness,  nausea,  sleeplessness, 
loss  of  memory,  and  even  hallucinations,  may  occur ;  while  at  a 
height  of  over  25,000  feet  unconsciousness,  hemorrhages,  cyanosis, 
and  symptoms  of  paraplegia  have  been  noted. 

The  observations  taken  by  Whymper  during  his  ascents  of  the 
Andes,'  and  those  of  Conway  while  climbing  the  Himalayas,-  with 
their  several  experiences,  are  interesting  and  instructive,  especially 
when  studied  together.  They  illustrate  the  physiological  effects  of 
diminished  barometric  pressure  upon  mountain-climbers  in  normal 
health.  Both  Whymper  and  Conway,  and  most  of  their  com- 
panions, had  been  accustomed  to  mountaineering  at  lower  elevations 
in  the  Alps.  Both  experienced  mountain-sickness  the  first  time, 
within  three  weeks  of  their  arrival  in  the  country,  Whymper  at  an 
elevation  of  about  15,000  feet,  ten  days  after  landing.  Neither 
felt  it  appreciably  again  at  as  low  a  level.  Whymper,  a  week 
later,  after  climbing  to  a  height  of  16,664  feet,  was  more  affected 
than  on  the  first  occasion.  However,  after  being  four  weeks  in  the 
country,  he  reached  the  summit  of  Chimborazo  (20,608  feet),  the 
highest  mountain  he  scaled,  with  very  little  discomfort.  Conway, 
about  three  months  after  his  arrival,  reached  18,600  feet,  also  with- 
out any  mountain-sickness.  About  two  weeks  later,  however,  on 
reaching  the  top  of  Pioneer  Peak,  22,600  feet,  he  experienced  very 
serious  symptoms.  This  was  the  greatest  height  he  climbed,  and  he 
doubted  if  they  could  have  gone  any  higher. 

The  fact  that  both  Conway  and  Whymper  were  affected  within 
three  weeks  of  their  beginning  to  climb  heights  between  15,000  and 
16,000  feet,  and  later  were  only  slightly  disturbed  at  various  eleva- 
tions up  to  20,000  feet,  points  to  an  improved  capacity  for  climbing 
due  to  the  increased  power  of  oxygen-absorption  of  the  blood,  which 
the  diminished  pressure  usually  effects  in  the  first  four  weeks,  as  was 
proved  by  Regnard's  experiments,  mentioned  elsewhere.  This  expla- 
nation is  confirmed  by  the  fact  that  they  had  very  little  mountain- 
sickness  after  the  first  four  weeks,  except  when  Conway  reached  a 
much  greater  height.  They  both  speak  of  headache,  dizziness,  gasp- 
ing for  breath,  rapid  pulse,  an  occasional  slight  rise  of  temperature, 
and  difficulty  in  exerting  themselves.  Freedom  from  nausea  and 
vomiting  seemed  to  depend  somewhat  upon  how  and  what  they  ate; 
the  best  plan  being  to  eat  sparingly  but  frequently  of  light  food,  such 

1  Travels  among  the  Great  Andes  of  the  Equator.    Edward  Whymper. 
-  Climbing  in  the  Himalayas.    W.  M.  Conway. 


46  MEDICAL  CLIMATOLOGY. 

as  kola-biscuits,  chocolate,  meat-peptones,  and  also  to  drink  a  little 
brandy  (Conway).  There  was  some  difficulty  in  sleeping  after  the 
climbing  had  been  especially  hard.  Whymper  says  they  became 
somewhat  accustomed  to  low  pressures,  and  while  they  were  never 
able  to  work  as  fast  as  at  sea-level,  they  improved  much  in  this 
respect.  They  had  no  hemorrhages,  vomiting,  or  nausea,  and  the 
absence  of  the  latter  he  attributed  to  careful  and  spare  dieting. 

Whymper,  in  order  to  see  if  he  could  make  as  good  time  at  a 
height  as  at  the  sea-level,  walked  six  miles  on  a  flat  road  at  an 
altitude  of  10,000  feet,  and  compared  it  with  a  walk  of  the  same 
distance  previously  taken  at  sea-level.  He  knew  his  usual  pace, 
and  kept,  as  far  as  he  could,  the  same  stride  on  both  occasions,  and 
the  other  conditions  he  considers  were  about  equal.  He  found 
that  it  took  him  54  seconds  more,  on  the  average,  to  walk  a  mile  at 
10,000  feet  elevation  than  at  sea-level.  His  pulse  before  starting 
in  both  places  was  nearly  the  same,  78  ;  but  at  the  finish  at  sea- 
level  it  was  raised  to  96,  and  on  the  high  ground  to  101. 

With  respect  to  the  ability  of  athletes  to  perform  their  accustomed 
feats  as  well  at  a  high  altitude  as  at  sea-level,  I  have  made  some 
inquiries  about  the  racing  of  well-known  professional  runners  on 
the  track  at  Denver  (altitude,  5280  feet).  I  find  that  when  they 
attempt  to  equal  their  record  within  the  first  few  weeks  after 
arriving  they  usually  fail  to  do  so  in  long-distance  races;  but  in 
short  ones  they  sometimes  exceed  it,  as  did  H.  M.  Johnson,  on 
August  18,  1889,  when  he  ran  a  hundred  yards  in  9f  seconds, 
beating  his  previous  record  of  9|^  seconds  (Cleveland,  July  31, 
1886),  and  making  the  best  time  on  record. 

AVith  few  exceptions,  neither  the  best  professional  runners  nor  the 
wheelmen  of  the  same  class  have  raced  on  the  Denver  track;  but 
the  information  that  I  have  collected  as  to  the  records  which  have 
been  made  there  seems  to  render  the  following;  results  certain:  in 
sprinting,  both  on  foot  and  on  the  wheel,  better  time  has  been  made 
at  Denver  than  elsewhere,  as  the  appended  evidence  shows.'     For 

1  Bicycling  records,  from  tiie  New  York  Referee  Calendar  for  1896 : 

880  yards,  paced,  51  seconds.    B.  B.  Bind,  against  time,  Denver,  Col.,  Oct.  19, 1895.    The  best 
world  record. 
Unpaced,  59  seconds.    Harry  Clark,  against  time,  Denver,  Col.,  Nov.  20, 1895. 
In  competition,  58^5  seconds.    C.  M  Murphy,  Denver,  Col.,  Oct.  19, 1895. 
2/3  mile,  unpaced,  1.211/5.    H.  Clark,  Denver,  Col.,  Oct.  17,  1895. 
1  mile,  unpaced,  2.00-/5.    W.  W.  Hamilton,  against  time,  Denver,  Col.,  Oct.  12,  1895. 
1  mile,  paced  (Class  A),  I.543/5.    p.  Becker,  Denver,  Col..  Oct.  19,  1895. 

1  mile,  2.022/5.    C.  C.  Collins,  in  competition,  Denver,  Col.,  Oct.  17,  1895. 

2  miles,  unpaced,  4.46V6.    H.  Clark,  Denver,  Col.,  Nov.  21, 1895. 

3  miles,  unpaced,  7.15.    H.  Clark,  Denver,  Col.,  Nov.  21,  1895. 


PHYSIOLOGY.  47 

distances  from  half  a  mile  to  three  miles  there  is  a  gradual  falling 
off,  and  for  distances  over  three  miles  the  Denver  records  are  behind 
those  made  at  places  nearer  sea-level. 

Conway  found  that  when  he  was  at  a  great  height  the  discomfort 
of  breathing  was  relieved  by  increasing  the  rate  of  respiration,  some- 
times to  38  per  minute,  and  was  made  worse  if  a  cramped  position 
was  taken  while  climbing.  The  symptoms  were  much  slighter  when 
he  was  at  rest  than  while  he  was  exerting  himself.  Both  he  and 
Whymper  found  smoking  enjoyable  except  when  they  were  suffering 
from  mountain-sickness.  Conway  further  says  that  when  he  was  at 
22,600  feet  he  had  to  walk  very  slowly,  and  found  any  exertion 
difficult.  His  breathing,  however,  was  very  little  affected  at  that  time, 
especially  when  he  was  in  repose.  He  had  then  been  about  three 
months  in  the  country.  "  But  the  sphygmograph  showed  their  hearts 
were  sorely  tried  and  that  they  had  reached  the  limit  of  their  powers," 
He  could  not  sleep  that  night,  and  "  felt  his  heart  racing  like  a  screw 
out  of  water."  These  feelings  lasted  even  after  he  got  down  to  camp 
at  20,000  feet;  but  the  next  day  they  descended  to  8640  feet,  where 
they  slept  long  and  heavily,  ate  heartily,  and  felt  much  relieved, 
Conway  found  that  the  symptoms  of  mountain-sickness  came  on  at 
lower  levels  than  usual  when  the  sun  was  hot  or  when  they  were 
travelling  through  a  close  ravine.  After  a  few  weeks  of  climbing  he 
noticed  that  the  rate  of  the  pulse  and  of  respiration  as  well  as  the 
body-temperature  had  again  become  normal. 

Whymper  refers  to  the  difference  between  climbing  a  mountain 
gradually  and  rising  rapidly  in  a  balloon,  which  latter,  he  says,  is 
much  more  dangerous. 

In  the  chapter  upon  Elevated  Climates  the  subject  of  barometric 
pressure  is  dwelt  upon  at  greater  length. 


CHAPTER   III. 

ETHNOLOGY. 

It  is  now  generally  admitted  that  the  chief  characteristics  of  race 
are  mainly  due  to  climatic  causes.  This  view  is  supported  by  the 
fact  that,  with  the  exception  of  the  Mongolian  and  Ethiopian  races, 
the  progeny  of  nativ^es  of  one  climate  who  become  permanent  resi- 
dents of  another  exhibit  the  peculiarities  of  the  people  among  whom 
they  are  living  and  lose  those  of  their  ancestors.  This  even  applies 
to  a  stronger  race  which  may  settle  as  conquerors  of  a  new  country. 
As  to  the  two  races  mentioned  above,  it  is  suggested  that  they  hav- 
ing been  for  so  long  domiciled  amidst  unchanged  climatic  influences, 
with  little  or  no  admixture  with  other  races,  are  merely  slower  to 
lose  their  original  racial  traits. 

The  normal  being  can  accustom  himself  to  and  thrive  in  any 
climate,  the  inhabitants  of  temperate  climates  naturally  excelling  in 
this  capacity.  In  spite  or  rather  because  of  their  rapid  and  unex- 
pected changes,  impossible  to  foresee  or  guard  against, variable  climates 
have  a  most  favorable  influence  upon  the  robust  development  of  the 
bodily  and  mental  powers.  The  natives  of  northerly  inland  coun- 
tries, while  they  suffer  from  the  extremes  of  temperature,  are  less 
exposed  to  those  endemic  sources  of  disease  which  produce  so  much 
illness  and  death  in  low  or  level  countries  and  in  more  southerly 
climates,  and  the  very  vicissitudes  of  climate,  by  training  the  system 
to  endure  severe  physical  conditions,  must  react  favorably  upon 
the  mental  attitude.  As  Copland  has  said,"  The  physical  and  moral 
history  of  the  British  Isles,  Denmark,  Sweden,  and  the  more  con- 
tinental districts  of  western  Europe  demonstrates  this  fact." 

The  inhabitants  of  the  countries  of  eastern  Europe,  Central  Asia, 
and  North  America,  on  the  contrary,  have  been  led,  by  the  greater 
regularity  of  seasonal  changes,  to  the  adoption  of  precautionary 
measures  and  a  more  luxurious  mode  of  living,  which  depress  the 
vitality,  encourage  disease,  enfeeble  the  frame,  and  shorten  the  mean 
duration  of  human  life.  The  practice  of  living  in  overheated  houses 
unfits  the  frame  to  bear  the  rigor  of  the  cold,  dry,  external  atmos- 


ETHNOLOGY.  49 

phere,  and  hence  the  alternation  from  one  to  the  other  produces 
diseases  of  the  thoracic  and  abdominal  viscera. 

In  natives  of  northern  climates  the  functions  of  the  lungs  and 
kidueys  are  very  extended,  while  those  of  the  liver  and  skin  are 
much  more  limited.  In  natives  of  temperate  countries  all  the 
emunctories  are  stimulated  to  a  great  and  more  equal  degree  of 
activity,  but  in  the  warmer  districts  of  such  countries  the  respira- 
tory changes  are  lessened,  while  those  brought  about  by  the  intes- 
tinal mucous  surfaces  are  increased,  and  this  is  especially  true  of 
districts  the  atmosphere  of  which  is  damp  as  well  as  warm. 

It  may  be  said,  in  a  general  way,  that  in  intertropical  countries 
the  conditions  given  for  temperate  climates  are  reversed.  The  skin 
of  the  white  man  performs  its  functions  to  a  very  limited  degree 
compared  to  that  of  the  negro,  for  instance,  which  differs  not  only 
in  color  but  also  in  texture.  Through  this  latter  peculiarity  it  is 
enabled  to  perform  excretory  functions  in  aid  of  the  respiration  and 
biliary  secretion,  and  its  action  compensates,  to  some  extent,  for  the 
diminished  action  of  lungs,  hver,  and  kidneys  which  has  been 
observed  in  the  natives  of  intertropical  climates.  It  gives  forth 
more  of  the  aqueous  fluid  and  carbonic  acid  from  the  blood  and 
elaborates  an  oilier  secretion  than  does  the  skin  of  the  white,  thus 
counteracting  the  extreme  effects  of  the  sun's  rays  and  carrying  off 
superabundant  caloric. 

'^  The  most  conspicuous  difference  in  the  external  aspect  of  .men 
and  of  races  of  men  is  in  color ;  and  here  comparative  pathology 
would  lead  one  to  look  for  some  corresponding  differences  in  sus- 
ceptibility to  disease,  for  the  experience  of  horse-breeders  and  veteri- 
narians is  pretty  clearly  expressed  on  this  point.  Thus  Youatt 
says  that  the  dark  chestnut,  as  a  rule,  yields  to  no  other  color  in 
any  quality;  but  that  the  light  chestnut,  which  appears  to  be  the 
analogue  of  the  sanguine  blond-man,  is  spirited,  but  irritable  and 
delicate  in  constitution.  Black  horses,  again,  number  among  them 
some  of  the  very  finest  of  their  species  ;  but  many  of  them  are  heavy 
and  dull  in  temperament,  and  there  is  an  idea  afloat  that  they  are 
particularly  liable  to  malignant  disease.  Here  we  may  be  led  to 
think  of  the  choleric  and  the  melancholic  temperaments.  Among 
breeds  of  sheep  the  black-faced  have  the  reputation  of  being  hardier 
than  the  white-faced.  Certain  black  pigs,  according  to  Darwin,  can 
eat  with  impunity  what  would  be  poisonous  to  white  ones  on  the 
same  pasture ;  and  like  differences  are  seen  in  black  and  white  rats. 

4 


50  MEDICAL  CLIMATOLOGY. 

On  the  whole,  however,  the  deposition  of  pigment  in  the  skin  and 
hair  of  mammals  would  seem  to  be  the  result  of  processes  which 
connote  or  accompany  health  and  vigor  rather  than  the  opposite. 

"  The  statistics  of  morbidity  and  mortality,  which  alone  could  yield 
a  sound  foundation  for  generalizations  on  this  subject,  are  unfortu- 
nately imperfect  or  altogether  wanting  in  the  regions  where  the 
material  would  be  most  valuable — those  regions,  namely,  where 
nations  of  different  colors  and  constitutions  of  body  live  side  by 
side  under  comparable  conditions.  In  fact,  we  have  hardly  any 
trustworthy  statistics  except  from  the  most  civilized  of  the  countries 
whose  populations  are  compounded  from  more  or  less  distinct  divi- 
sions of  the  human  race  {vide  Dr.  Billings's  article  on  '  Medical 
Statistics').'" 

If,  then,  it  be  admitted  that  the  effects  of  climate  upon  the  in- 
habitants of  different  countries  are  so  definite  and  so  obvious,  it 
must  be  plain  that  they  are  closely  associated  with  the  nature  of 
disease  and  with  its  treatment. 

Let  us  now  consider  the  relations  between  food  and  the  soil  and 
climate  which  produce  it,  together  with  their  combined  operation 
upon  man,  who  must  be  acknowledged  to  be  in  a  degree  the 
creature  of  both.  His  moral  and  physical  development  is  modified 
and  limited  by  both,  and  therefore  the  natural  history  and  the  dis- 
eases of  the  inhabitants  of  a  country  cannot  be  comprehensively 
viewed  without  taking  account  of  the  productions  of  the  soil  by 
which  they  live. 

It  must  be  remembered,  however,  that  man  is  as  much  the 
moulder  of  circumstances  as  he  is  their  product;  that  he  can  accus- 
tom himself  to  bear  alike  an  equatorial  heat  or  the  rigors  of  an 
arctic  temperature.  No  one  sort  of  diet  is  necessary  to  his  well- 
being,  nor  is  a  mixed  diet  required.  He  must  to  some  extent  eat 
as  his  environment  demands.  "  The  Russians  who  winter  in  Nova 
Zembla,  according  to  Dr.  Aiken,  imitate  the  Samoieds  and  eat  raw 
flesh  and  drink  the  blood  of  reindeer  in  order  to  preserve  their  health 
in  these  arctic  regions."^ 

Tropical  Reg-ions.  In  these  regions  the  extreme  and  constant 
heat  tends  to  stimulate  the  vascular  and  nervous  systems,  the  effects 
of  high  temperature  being,  however,  largely  modified  by  the  amount 
of  humidity. 

1  Allbutt's  System  of  Medicine,  vol.  vi.  p.  21. 

2  Copland's  Medical  Dictionary,  vol.  i. 


STATE  MEDICAL  LIBRARY 

UNIVERSITY  OF  CALIFORNIA 

742  NORTH  BROADWAY 


ETHNOLOGY.  51 

It  has  always  been  stated  that  the  increased  fiiuetiou  of  the  skin 
of  intertropical  races  tends  to  modify  the  extreme  effects  of  the  sun's 
rays  and  to  give  off  superabundant  animal  heat.  A  heat- making 
diet  of  flesh  would,  then,  be  entirely  unsuitable  to  the  needs  of  these 
people,  and  even  a  mixed  diet,  such  as  is  required  by  the  inhabi- 
tants of  temperate  climates,  would  be  harmful  here.  But  tropical 
countries,  while  they  offer  the  most  lavish  supply  of  productions  of 
the  vegetable  kingdom,  provide  few  of  those  gregarious  animals 
which  are  used  as  food,  and  some  of  these  are  pronounced  sacred 
by  the  dominant  systems  of  religion.  Therefore,  the  natives,  except 
perhaps  in  cool,  elevated  districts,  are  driven  to  adopt,  because  it  is 
easily  procured,  a  vegetable  diet,  by  which  their  health  is  main- 
tained. In  conjunction  wnth  this  diet  the  inhabitants  of  inter- 
tropical regions  are  accustomed  to  consume  a  large  quantity  of  the 
hot  spices  indigenous  to  these  localities.  These  stimulate  the  sys- 
tem, largely  counteract  the  effects  of  the  lowered  temperature  and 
unhealthy  emanations  consequent  upon  the  rainy  seasons  and  mon- 
soons, and  give,  to  a  certain  extent,  immunity  from  intestinal  worms 
and  other  parasitic  animals. 

It  is  certainly  a  fact  that  the  causes  of  disease  are  nowhere  more 
energetic  than  in  tropical  countries,  but  comparatively  few  maladies 
arise  from  the  nature  or  wrong  use  of  food,  the  prevalent  diseases 
being  chiefly  such  as  proceed  directly  from  the  soil  and  climate,  and 
the  same  region  which  produces  a  disorder  produces  also  its  most 
powerful  remedy  or  prophylactic. 

Polar  Reg-ions.  In  high  latitudes  man's  requirements  are  the 
direct  opposite  of  those  necessitated  by  warm  climates.  The  low- 
ered temperature  and  the  lack  of  sunlight  during  the  greater  part  of 
the  year  tend  to  depress  the  vitality,  lessen  nervous  and  vascular 
energy,  and  lower  the  tone  of  the  system. 

In  order  to  counteract  the  prejudicial  etfects  of  the  climate  the 
inhabitants  have  sought  and  found  the  best  possible  food  for  their 
needs,  viz.,  an  animal  diet  especially  rich  in  fat  and  oil,  which  are 
the  great  heat-producers.  By  these  means  their  nerve-force,  rich- 
ness of  the  blood,  and  bodily  heat  are  maintained  at  a  very  high 
level,  and  they  are  enabled  to  preserve  their  health  in  spite  of  the 
extreme  rigors  of  the  climate. 

Temperate  Climates.  The  north  temperate  zone,  possessing  the 
greatest  diversity  of  climates,  provides  a  plentiful  supply  of  both 
animal  and  vegetable  food,  and  man  is  thus  enabled  to  adapt  his 


52  MEDICAL  CLIMATOLOGY. 

diet  to  the  seasons  or  to  the  climate  of  the  locality  in  which  he  lives. 
If  the  population  of  any  district  should  increase  through  the  demands 
of  commerce  or  manufacture,  until  its  requirements  exceed  the 
means  of  support  furnished  by  such  locality,  the  necessary  food 
should  be  imported  from  a  similar  climate,  otherwise  it  is  apt  to 
prove  unwholesome.  The  consumption  of  unwonted  luxuries  brought 
from  distant  countries  often  produces  disease,  and  this  remark  applies 
also  to  the  unusual  and  unsuitable  preparation  of  food  which  may 
in  itself  be  harmless. 

The  warmer  the  climate  the  more  necessary  is  it  to  approximate 
to  the  conditions  suitable  to  life  in  tropical  countries,  whereas  cooler 
climates  demand  a  freer  adoption  of  those  rules  necessary  to  exist- 
ence in  high  latitudes. 

From  these  statements  the  following  obvious  conclusions  may  be 
drawn  :  first,  it  is  generally  true  that  man  finds,  indigenous  to 
the  country  in  which  he  may  chance  to  be,  the  food  most  suitable 
to  the  climatic  conditions ;  secondly,  the  nature  of  the  food  con- 
sumed by  him  unites  with  the  climate  to  modify  as  well  as  to  sup- 
port his  constitution.^ 

The  Effects  of  Climate.  If  the  foregoing  pages  have  made  clear 
the  action  of  cold  or  warm  climates  upon  the  human  frame  and  con- 
stitution, it  will  be  easily  understood  that  the  effects  of  climatic 
change  are  important  in  direct  ratio  to  the  suddenness  and  degree  of 
such  change,  and  that  they  include  some  disturbance  of  the  normal 
action  of  the  system,  temporary  or  otherwise,  frequently,  though  not 
necessarily,  giving  rise  to  fever. 

1  Much  of  the  material  for  this  chapter  may  be  found  in  the  article  upon  climate  in  Cop- 
land's Dictionary  of  Practical  Medicine. 


CHAPTER  IV. 

GEOGRAPHICAL  DISTRIBUTION  OF  DISEASE. 

It  would  appear,  speaking  broadly,  that  the  tendency  to  disease 
in  an  organ,  particularly  if  o£  an  inflammatory  character,  is  in 
pro5^)ortion  to  its  functional  activity.  Though  all  the  organs  act 
more  equally  in  temperate  climates  than  in  extreme  ones,  yet  the 
chief  labor  devolves  upon  the  kidneys,  and  so  renal  diseases  are 
more  common  ;  while  in  hot  climates  the  liver,  bowels,  and  skin 
being  more  active,  such  diseases  as  hepatitis,  dysentery,  and  leprosy 
abound.  In  cold  climates  the  secretion  from  the  kidneys,  liver,  and 
bowels  is  moderate,  and  that  from  the  skin  especially  limited,  so  the 
work  is  chiefly  performed  by  the  lungs.  Therefore,  pneumonia, 
bronchitis,  etc.,  are  frequent.  It  has  been  shown  elsewhere  that 
humidity  greatly  modifies  these  tendencies.  And,  further,  within 
certain  limitations,  it  is  often  true  that  a  climate  which,  by  its  stimu- 
lating qualities,  tends  to  provoke  acute  disease,  through  the  same 
causes  mitigates  or  removes  certain  chronic  affections  which  are  the 
results  of  previous  illnesses. 

Germ-diseases,  We  find  that  contagious  diseases  are  naturally 
most  prevalent  in  crowded  districts,  and  that  contagion  may  prove 
stronger  than  climatic  influences;  the  latter  may  modify  its  manifesta- 
tions and  progress,  but  canuot  always  prevent  them.  This  accounts 
for  the  fact  that  such  diseases  as  scarlatina,  measles,  diphtheria,  etc., 
are  found  in  all  climates,  and  it  is  also  true,  in  a  somewhat  less 
degree,  of  tuberculosis,  as  will  be  shown  later. 

However,  as  some  germs  grow  more  vigorously  or  solely  in  high 
temperatures,  for  instance,  those  of  yellow  fever,  and  some  more 
vigorously  in  low  temperatures,  as  those  of  smallpox,  climate  does 
modify  many  of  the  germ-diseases.  The  degree  of  humidity  in 
the  air  has  also  an  influence  on  germ-life,  but  not  nearly  so  much 
as  has  the  amount  of  moisture  in  the  soil.  This  is  notably  the  case 
with  the  germs  of  malaria,  and  in  sending  patients  to  damp  climates 
the  condition  of  the  soil  Avith  respect  to  its  moisture  must  be  par- 
ticularly inquired  into.  Speaking  broadly,  it  may  be  said  that 
germ-diseases  are  more  active  in  hot  than  in  cold  climates,  and  in 
damp  than  in  dry  ones. 


54 


MEDICAL  CLIMA TOLOGY. 


Some  germ-diseases  are  contagious,  some  spread  only  by  infection 
through  the  air,  some  only  through  water  and  food,  and  some  in  all 
these  ways,  as  does  malaria. 

Death-kates  per  1000  Deaths  from  all  Causes.^ 


Countries. 


England  and  Wales 
Ireland 
Scotland 
ium 
Sweden 
Prussia 
Austria 
Saxony 
Norway 

Rhode  Island 
Connecticut 
Massachusetts 
New  Jersey 


Periods. 

o 
ft 

a 

03 

i 

> 

c3 
•t, 
o 

Xi 

ft 

5 

ft 
P 

1880-89 

2.5 

23.1 

19.6 

8.1 

1 
15.3  23.6 

1880-89 

0.7 

10.7 

13.8 

3.8 

14. 6  16. 8 

1880-89 

0.2 

18.9 

16.9 

10.9 

21.9 

31.1 

1880-87 

15.7 

25.1 

12.4 

27.1 

32.8 

1880-89 

1.0 

11.0 

30.3  34.1 

42.3 

10.7 

1880-89 

0.6 

le.-? 

18.3 

65.7 

20.8 

1877-86 

19.9 

16.4 

20.0 

53.7 

35.7 

1881-90 

9.4 

13.8 

55.0 

9.9 

1880-89 

0.3 

6.3 

21.8 

33.0 

10.4 

1880-89 

0.1 

5.3 

26.6 

29.9 

45.1 

7.9 

1880-89 

0.5 

5.4 

15.8 

32.4 

47.2 

6.9 

1880-90 

0.4 

5.7 

12.2 

34.2 

48.3 

6.5 

1880-89 

3.0 

5.8 

25.5 

53.4 

7.9 

10.6 
9.1 
12.8 
26.1 
15.2 
15.4 
23.4 
7.7 
6.4 


j-i3        .SS 


53.6;  90.9     39.5     29.8  '     7.8 
29.4  115.8     18.1      21.8       9.3 


54.0 


104. 7      25. 6     29.  6 

73.6      

25.4      


9.1 
11.2 
6.8 
8.4 


56. 5  122. 6  41. 8  ;  14. 4 

126.0  13.9  

I  85.7  26.3  

46. 5!  82.7  29.7  12.3 


27. 6  75. 7  133. 7  86.  2  29.  0  5. 7 
22.9  75.3124.5  80.3  25.3  5.8 

23.7  82.11151.3  74.7  28.4  ;     4.9 
25.8' 1131.3  116.5  21.3      


The  almost  universal  distribution  of  certain  diseases,  even  in 
places  and  under  circumstances  which  make  it  impossible  to  believe 
that  the  virulence  of  the  germs  can  have  been  derived  from  another 
case  (there  having  been  no  previous  cases  of  illness  of  any  kind  in 
the  neighborhood),  suggests  the  theory  that  the  germs  of  these  dis- 
eases may  be  almost  universally  present  in  an  innocent  state,  and  only 
become  virulent  when  they  are  brought  into  contact  with  certain 
conditions  inside  or  outside  of  the  body. 

Take,  as  an  instance,  typhoid  fever,  which  has  been  proved  not  to 
spread  through  the  air,  but  only  through  food  or  water  in  which  the 
germs  are  present;  while,  without  doubt,  it  usually  arises  from  the 
ingestion  of  germs  in  water  or  food  infected  by  other  typhoid  cases, 
yet  it  is  probable  that  it  does  sometimes  occur  without  being  derived 
from  another  case.  The  body  of  the  patient  has  perhaps  been  sub- 
jected to  an  unusual  waste  of  tissue,  such  as  comes  from  prolonged 
or  violent  muscular  exertion,  and  there  has  been  imperfect  elimina- 


1  AUbutt's  System  of  Medicine,  vol.  vi.  p.  17. 


GEOGRAPHICAL  DISTRIBUTION  OF  DISEASE.  55 

tiou  due  to  a  chill  or  other  cause,  and  thus  a  soil  is  furnished  within 
the  body  fitted  to  convert  the  harmless  germ  into  a  virulent  one. 

It  has  lately  been  suggested  that  the  bacillus  coli  communis  is 
identical  with  the  typhoid  bacillus,  as  the  former  is  present  in  the 
intestines  of  healthy  persons.  Some  also  think  that  the  comma- 
bacilli,  which  are  believed  to  be  the  cholera-germs,  may  sometimes 
be  innocent,  because  they  are  found  in  healthy  persons.  The  two 
diphtheria-bacilli,  identical  in  appearance,  one  innocent  and  one  viru- 
lent, furnish  another  instance. 

In  accordance  with  this  theory,  one  may  have  chosen  a  health- 
resort  possessing  good  sanitary  conditions  and  yet  cases  of  typhoid 
may  present  themselves,  and  some  of  the  problems  afforded  by  the 
connection  between  germ-diseases  and  climate  may  thus  be  explained. 
As  we  are  only  at  the  beginning  of  the  scientific  study  of  both  germ- 
life  and  climate,  it  is  not  surprising  that  we  have  to  resort,  in  dis- 
cussing them,  more  to  speculation  than  to  proof. 

Fortunately,  most  of  the  germ-diseases  are  not  those  maladies  for 
which  change  of  climate  is  sought,  and  therefore  are  not  of  material 
importance  in  a  practical  treatise  such  as  this  aims  to  be.  The  dis- 
eases which  chiefly  concern  the  invalid  and  his  advisers  will  be 
discussed  under  their  different  heads  in  the  part  devoted  to  climato- 
therapy. 

The  Modification  of  Disease  by  Season  and  Weather  over 
and  above  the  General  Influence  of  the  Different  Climates. 
Regular  variations  in  the  curves  of  mortality  and  sickness  are 
noted  as  the  seasons  change,  and  these  normal  variations  may  be 
influenced  by  exceptionally  bad  or  good  seasons.  The  changes  of 
weather  from  day  to  day  also  modify  the  normal  seasonal  curves. 
Dr.  Weber  has  demonstrated  this  subject  so  clearly  that  I  quote  as 
follows  •} 

'^  A  mere  glance  at  the  health  and  mortality  statistics  for  different 
seasons,  and  under  different  conditions  of  weather,  shows  the  influ- 
ence of  different  climatic  factors  on  the  state  of  health  of  the  popula- 
tion, and  the  different  seasons  represent  to  a  certain  extent  different 
climates.  Thus,  when  the  weather  is  moderately  cool,  being  at  the  same 
time  moist  and  liable  to  sudden  changes,  we  observe  the  prevalence  of 
rheumatic  affections  and  of  catarrhal  and  inflammatory  states  of  the 
respiratory  organs.     At  a  still  lower  temperature  of  the  air,  without 

1  Von  Ziemssen's  Handbook  of  General  Therapeutics,  vol.  iv.  p.  4. 


56  MEDICAL  CLIMATOLOGY. 

moisture,  but  more  so  with  it,  we  notice  that  in  temporarily  or  per- 
manently weak  subjects  most  of  the  functions  of  the  body  suffer,  and 
that  in  aged  people  apoplexies  become  more  frequent.  In  hot  weather 
there  appears  a  tendency  to  diarrhoea  and  to  other  diseases  of  the  ab- 
dominal organs.  On  the  other  hand,  we  find  that  during  the  mild 
or  moderately  warm  and  not  too  damp  weather  of  the  second  half  of 
spring  and  beginning  of  summer,  many  chronic  affections,  particu- 
larly chronic  catarrhs  and  chronic  rheumatisms,  improve  consider- 
ably, and  that  weakly  people  gain  in  appetite  and  digestive  power, 
blood-formation,  and  muscular  force.  We  notice  also  that  persons 
with  chronic  catarrh  and  emphysema  suffer  less  during  the  preva- 
lence of  warm  or  moist  weather,  and  are  more  able  to  undergo 
fatigue,  while  many  subjects  with  chronic  dyspepsia  and  tendency 
to  depression  of  spirits  and  hypochondriasis  always  feel  better  and 
seem  like  quite  different  persons  when  the  temperature  is  moder- 
ately cold  and  there  is  a  clear  sky  with  sunshine.  To  remove  per- 
sons to  climatic  conditions  in  which  the  influences  of  certain  seasons 
hurtful  to  them  are  as  far  as  possible  absent,  but  where  the  favor- 
able influences  of  other  seasons  prevail,  is  the  chief  object  of  climatic 
treatment." 

The  geographical  distribution  and  prevalence  of  phthisis  are  the 
most  important  matters  to  be  considered  in  connection  with  change 
of  climate  for  invalids,  and  they  are  discussed  in  the  chapter  on 
Phthisis  in  Section  II. 


CHAPTER    V. 


CLASSIFICATION  OF  CLIMATES. 

This  is  a  task  which  it  is  impossible  to  cany  out  with  scieutific 
accuracy  because  of  the  intimate  relation  which  the  various  climatic 
factors  sustain  to  each  other,  the  local  modification  of  general  laws, 
and  the  seasonal  variations.  On  this  account  it  can  only  be  treated 
in  a  broad  aud  general  way. 

Tt  is  admissible  to  classify  climates  according  to  their  physiological 
effects  (as  stimulating  or  sedative,  etc.)  or  therapeutically;  but  such 
division  should  be  preceded  by  a  classification  based  upon  their  phy- 
sical peculiarities.  The  tabulation  should  be  made,  first,  in  reference 
to  their  position,  by  separating  them  into  sea  aud  land  climates,  with 
their  subdivisions  (as  in  Table  A) ;  and,  secondly,  according  to  tem- 
perature, these  groups  being  again  divided  by  humidity  (as  in  Table 
B).     All  of  these  may  be  regarded  as  subdivisions  of  Table  A. 

Table  A. — Position. 

i  Ocean  climates. 
Sea  climates  .     .     .  <  Island  climates. 

( Coast  climates. 

c  Low  climates  (up  to  2500  feet). 
Land  climates    .     .  <  Medium  climates  (elevation  up  to  4500  feet). 

i  High  climates  (elevation  from  4500  feet  upward)- 


Cold  climates 


Table  B. — Temperature  and  Humidity 

(Moderate     f   Dry 

I 

■> 

[  Moist 


Extreme 


Hot  climates 


{Moderate 
Extreme 


r  Dry       { 


[  Moist 


Moderate  climates. 
Extreme  climates. 
Moderate  climates. 
Extreme  climates. 
Moderate  climates. 
Extreme  climates. 
Moderate  climates. 
Extreme  climates. 


Ocean.  The  air  over  the  ocean  is  always  damp,  owing  to  the 
constant  evaporation;  the  rainfall  is  usually  large,  and  fogs  are  not 
infrequent.     In  southern  latitudes,  however,  and  at  certain  seasons 


58  MEDICAL  CLIMATOLOGY. 

there  is  often  very  little  rain  and  fog,  which  may  be  partly  explained 
by  the  fact  that  the  constant  evaporation,  with  the  presence  of  an 
excess  of  water-vapor  in  the  atmosphere,  modifies  the  power  of  the 
sun's  rays  and  makes  the  change  between  night  and  day  and  between 
winter  and  summer  less  marked,  equability  of  temperature  being  one 
of  the  most  notable  features  of  an  ocean  clinaate.  The  air  is  impreg- 
nated with  salt  and  iodine  and  bromine,  and  is  strongly  ozonized. 
There  is  much  movement  of  air,  and  winds  from  a  distance,  not 
being  diverted  by  shelter,  often  bring  with  them  the  climate  of  dis- 
tant lands,  and  so  modify  natural  equability. 

-  The  ocean-currents,  such  as  the  Gulf-stream,  the  Kurosiwo  (the 
great  Japan  current),  or  the  cold  waters  from  the  arctic  regions,  also 
modify  the  climate  in  different  parts  of  the  ocean,  the  Gulf-stream 
in  some  regions  increasing  the  atmospheric  humidity. 

Physiological  Effects.  The  radiation  of  heat  from  the  body  is 
therefore  greater,  and  warmer  clothing  is  needed.  Metabolism  is 
more  active,  and  the  bodily  weight  increases,  as  do  usually  the  appe- 
tite and  the  inclination  to  sleep.  The  nervous  system  is  soothed. 
In  short,  on  those  with  whom  it  agrees,  the  air  of  the  ocean  acts 
as  a  sedative  tonic. 

Sea-bathing-.  The  uses  and  effects  of  this  usually  agreeable  and 
valuable  therapeutic  agency  are  admirably  put  by  Dr.  W.  M.  Ord,  of 
London,  who  says:  "■  The  great  benefits  derived  from  the  inhalation 
of  fresh  sea-air  and  from  sea-bathing  cannot  be  too  highly  appre- 
ciated, but,  as  in  the  case  of  all  other  remedial  agents,  their  use  has 
its  bounds  and  its  qualifications.  People  accustomed  to  a  non- 
invigorating  inland  atmosphere  cannot  with  impunity  expose  them- 
selves to  the  often  keen  air  of  the  seaside.  As  a  rule,  they  require 
warmer  clothing  than  at  home;  and  when  want  of  strength  reduces 
the  power  of  taking  exercise  the  sense  of  drinking  in  health  with 
the  air  does  not  justify  sitting  for  long  in  exposed  positions  and 
without  shelter.  In  respect  of  bathing  we  may  speak  more  strongly. 
Even  for  robust  persons  of  good  swimming-power  a  prolonged  im- 
mersion is  productive  of  exhaustion.  Doubtless  strong  people  and 
perhaps  even  weakly  ones  can  stay  in  the  stimulating  salt-water 
longer  than  in  fresh  without  feeling  the  bad  effects  of  the  lowering 
of  the  temperature  of  the  body  ;  and  it  must  be  admitted — nay, 
urged — that  every  individual  body  has  its  own  rule.  In  use,  even 
for  healthy  persons  coming  from  the  enervating  air  of  large  cities, 
the  first  baths  should  certainly  be  of  short  duration.      They  should 


CLASSIFICATION  OF  CLIMATES.  59 

include,  if  possible,  a  plunge  iuto  water  sufficient  to  cover  the  shoul- 
ders, and,  if  possible,  a  short  swim.  The  water  should  be  quitted 
in  a  few  minutes,  before  depression  has  followed  stimulation.  The 
condition  of  the  bather  after  the  resumption  of  his  clothes  will  soon 
afford  a  test  of  the  exposure  which  he  may  undergo  with  advantage. 
This  will  consist,  on  the  one  hand,  in  a  sense  of  warmth,  refresh- 
ment, and  readiness  for  muscular  activity  ;  on  the  other  hand,  sub- 
sequent feeling  of  nausea,  of  chilliness,  of  headache,  or  of  palpita- 
tion will  show  that  the  just  measure  has  been  exceeded.'" 

Island  Climates.  Moderate-sized  islands  away  from  the  coast 
enjoy  the  benefits  of  ocean-air  without  the  drawbacks  of  ship-life; 
but  their  climates  are,  of  course,  modified  by  currents,  and  by  coasts 
and  their  configuration. 

Coast  climates,  while  resembling  those  of  the  ocean  and  of 
islands,  are  less  equable,  owing  to  the  more  rapid  diurnal  radiation 
and  stronger  irregular  changes,  the  latter  being  truer  of  eastern  tem- 
perate coasts  than  of  western,  which  are  sometimes  more  humid  and 
their  rainfall  greater;  but  where  large  deserts  lie  adjacent  and  where 
the  prevailing  wind  is  seaward  these  conditions  are  often  reversed. 

Inland  climates  of  low  elevation  (under  2500  feet)  have  less 
ozone  and  less  purity  of  atmosphere  than  the  ocean  ;  but,  like  it,  they 
have  high  barometric  pressure,  which,  however,  diminishes  as  the 
land  ascends.  They  have  also  medium  humidity,  which  decreases 
with  distance  from  the  ocean,  though  this  is  modified  by  the  inter- 
vention of  mountain-ranges  on  which  the  humidity  is  partially  pre- 
cipitated, as  on  the  Coast  Range  of  California;  or  it  may  be  increased 
by  inland  seas  or  lakes  or  by  the  character  of  the  soil  or  vegetatiou. 
The  mean  temperature  usually  diminishes  with  distance  from  the 
equator,  and  the  changes  between  day  and  night  and  the  seasons  are 
more  marked  as  the  humidity  lessens  with  the  distance  from  the  ocean. 

Extreme  hot  and  cold  climates  (whether  moist  or  dry)  are,  for 
obvious  reasons,  unsuited  for  therapeutic  purposes. 

Moderately  moist,  warm  climates  are  often  of  service  because 
of  their  sedative  effects  upon  the  nervous  system  and  mucous  mem- 
branes; in  the  proper  season  the  even  temperature  and  moderate 
jirecipitation  permit  of  a  pleasant  outdoor  life.  Such  climates  are 
found  on  the  Riviera,  in  Italy,  and  in  southeastern  Georgia,  Florida, 
and  Southern   California.      They  are  useful  to  those  who  wish  to 

1  The  Climates  and  Baths  of  Great  Britain.  Royal  Medico-Chirurgical  Society,  London,  1895. 


60  MEDICAL  CLIMATOLOGY. 

avoid  the  rigors  of  their  horae-wiuter  aud  also  to  enjoy  more  open- 
air  life,  or  for  invalids  to  whom  climatic  extremes  are  unsuited. 

Moderately  moist,  cool  climates  have  no  positive  effects  or 
characteristics,  but  certain  of  the  resorts  in  such  climates  are  valuable 
because  they  afford  chauge  of  air  combined  with  pleasantness  of 
surroundings  and  accessibility.  In  these  climates  mineral  springs 
are  common,  as  at  Baden-Baden  aud  Saratoga.  Many  mountain- 
resorts  of  from  1500  to  3000  feet  elevation,  such  as  are  found  in  the 
Adiroudacks,  Allegheny,  aud  Cumberland  Mountains,  come  under 
this  head,  aud  these  are  of  more  service  to  a  certain  class  of  invalids 
than  resorts  of  less  elevation  because  they  are  sparsely  settled  and 
on  account  of  the  pine-woods  and  opportunities  for  camp-life  and 
sport. 

Moderately  dry,  warm  climates  are  rare  in  Europe.  Egypt 
aud  Algeria  are  the  most  resorted  to,  being  especially  noted  for  these 
qualities  ;  while  parts  of  the  lower  lands  of  Arizona,  New  Mexico, 
and  the  inland  regions  of  southeastern  California  furnish  examples 
on  this  continent.  They  have  a  positive  tonic  and  stimulating  char- 
acter, and  are  of  much  value  where  the  more  extreme  effects  of  higher 
ground  are  not  desirable.  They  would  be  more  frequented  were  it 
not  that  their  chief  qualification,  that  of  dryness,  has  prevented  their 
being  settled,  aud  so  they  are  apt  to  be  deficient  in  accommodations 
and  amusements.  For  permanent  residence  they  have  the  objection 
of  being  too  hot  in  summer. 

Moderately  dry,  cold  climates,  such  as  the  winter  climates  of 
parts  of  Canada,  Dakota,  Nebraska,  and  Miunesota,  are  healthful 
and  stimulating  to  the  robust,  but  are  too  severe  for  all  but  the 
strongest  class  of  invalids. 

Depressed  Climates.  These  are  the  climates  of  the  compara- 
tively few  spots  in  the  world  which  are  below  sea-level,  such  as  the 
so-called  sinks  near  the  Caspian  Sea,  the  valley  of  the  Dead  Sea,  and 
southeastern  California.  These  are  all  in  desert  countries,  and  are, 
therefore,  hot  and  dry;  they  will  be  more  fully  described  later. 

Elevated  Climates  (from  4500  feet  up)  all  come  under  the  head 
of  dry  climates,  while  they  are  both  cool  and  warm— that  is,  the  air 
itself  is  cool,  while  the  differences  between  sunshine  aud  shade  and 
day  and  night  are  very  marked;  seasonal  changes  are,  however, 
usually  not  extreme,  and  the  contrasts  referred  to  are  specially 
noticeable  in  winter. 

With  this  dryness  of  air  there  is  often  considerable  precipitation, 


CLASSIFICATION  OF  CLIMATES.  61 

much  rain  falling  at  a  time,  so  that  the  number  of  rainy  or  snowy 
days  is  generally  small  while  the  number  of  clear  days  is  very  large. 

The  direct  rays  of  the  sun  have  exceptional  power,  both  for  light 
and  heat.  The  air  is  usually  in  motion,  and  winds  are  frequent 
but  rarely  extremely  high;  germs  are  few,  and  the  air  is  aseptic  and 
highly  charged  with  ozone  and  positive  electricity.  The  soil  is 
commonly  dry  and  well  drained;  but  the  chief  peculiarity,  and  the 
one  upon  which  probably  mucii  of  the  therapeutic  merit  depends,  is 
the  lessened  barometric  pressure.  The  temperature  decreases  on  an 
average  of  1°  F.  for  every  300  or  400  feet  of  elevation. 

General  Physiolog-ical  Effects.  The  most  important  of  these 
effects  is  that  caused  by  the  rarefied  air,  which,  on  account  of  its  de- 
ficiency in  oxygen,  causes  an  increase  of  red  corpuscles  and  haemo- 
globin in  the  blood,  as  is  elsewhere  explained.  This  deficiency  in 
oxygen,  or  rather  in  oxygen-pressure,  at  first  compels  quicker  res- 
piration, but  later  causes  a  deeper  breathing,  which  permanently 
enlarges  the  chest.  As  a  consequence  of  this  rapid  breathing  the 
heart's  action  is  increased;  and  when,  later,  the  lespiration  becomes 
normal  in  rate,  though  increased  in  depth,  the  heart's  action  re- 
turns to  its  accustomed  rate,  but  each  beat  is  more  forcible  and  the 
cardiac  muscle  is  permanently  strengthened. 

''At  altitudes  varying  from  5000  to  8000  feet  the  inconvenience  of 
the  uuacclimated  seems  to  have  its  origin  in  the  increased  respiratory 
activity,  and  this,  in  turn,  leads  to  increased  work  of  the  heart, 
which,  by  its  overwork,  causes  at  first  an  active  hyperemia  and  an 
irritability  of  the  nerve-centres.  Later  the  nerve-centres  suffer  from 
imperfect  nutrition  induced  by  a  poor  blood-supply,  which  results 
from  passive  hypersemia.  We  have,  then,  the  '  irritable  weakness  " 
of  the  old  pathologists.  After  the  nerve-centres  have  become  irri- 
table, neither  the  respiratory  act  nor  the  heart's  action  is  performed 
as  regularly  and  methodically  as  in  the  normal  condition  ;  and  in 
consequence  various  unpleasant  symptoms  are  experienced  by  the 
nnacclimated.  Persons  possessed  of  considerable  vigor  and  capable 
of  adapting  themselves  to  greater  changes  in  their  environments  go 
to  high  altitudes  and  live  almost  as  they  had  done  at  sea-level,  and 
find  no  appreciable  inconvenience  in  doing  so ;  but  for  those  ad- 
vanced in  years  and  for  those  of  feeble  health  the  consequences  are 
far  different."^ 

1  Nervo-vascular    Disturbances  in    Unacclimated    Persons    in    Colorado.    J.  T.   Eskridge. 
Transactions  of  the  American  Climatological  Association,  1891. 


(32  MEDICAL  CLIMATOLOGY. 

The  foregoing,  in  conjunction  witli  what  appears  under  the  head 
of  decreased  barometric  pressure,  gives  the  chief  points  concerning 
elevated  climates.  Nothing  has  been  said  concerning  climates  in 
which  the  elevation  was  between  2500  and  4500  feet.  Though 
there  are  many  good  resorts  within  these  limits  which  exhibit  more 
or  less  the  characteristics  of  elevated  climates,  still  such  charac- 
teristics do  not  begin  to  be  markedly  manifested  at  less  than  4500 
feet  above  sea-level. 

Summer  and  Winter  Climates. 

Summer.  In  the  summer  of  1894  Professor  M.  W.  Harrington 
read  before  the  annual  meeting  of  the  American  Climatological  Asso- 
ciation an  original  and  instructive  paper  entitled  ^' Sensible  Tem- 
peratures," in  which  he  called  attention  to  the  importance  of  con- 
sidering the  agency  of  evaporation  in  lowering  the  actual  tempera- 
ture, in  order  to  judge  fairly  of  the  value  of  a  summer  climate. 

The  published  temperatures  for  the  ditferent  weather-stations  are 
the  readings  of  the  ordinary  dry-bulb  thermometer.  The  influence 
of  evaporation  is  shown  by  what  is  called  the  wet-bulb  thermometer, 
the  bulb  having  a  covering  of  cotton  or  muslin  which  is  kept  moist- 
ened. The  consequent  evaporation  from  the  surface  of  this  wetted 
bulb  is  similar  to  that  of  the  human  body  from  which  the  perspira- 
tion is  evaporated,  thus  causing  coolness.  The  temperature  shown 
by  the  wet-bulb  thermometer  is  called  the  "  sensible  "  temperature, 
and  is  supposed  to  be  the  temperature  felt  at  the  surface  of  the  skin. 
As  a  matter  of  fact,  it  is  probably  lower,  because  the  cloth  covering 
the  wet  bulb  is  continuously  saturated  with  water,  while  the  surface 
of  the  skin  is  usually  but  slightly  moistened,  and  is  not  subjected  to 
such  rapid  evaporation.  The  wind  is  an  important  factor  in  sen- 
sible temperature,  because  if  the  air  is  in  motion  that  portion  which 
is  in  contact  with  the  bnmin  body  is  continuously  replaced  by  dry 
air,  while  if  the  air  i;  tntionary  it  becomes  slightly  warmed  and 
more  humid  from  heav  ?nd  moisture  of  the  body,  and  the  amount 
of  evaporation  from  th  ^rface  of  the  skin  is  necessarily  less.  The 
amount  of  the  reductio,  r  cooling  of  temperature  is  in  direct  ratio  to 
the  dryness  of  the  aii  tilt  wlil  ^e  greatest  where  the  air  is  driest, 
least  where  the  air  is  >  ;ooI.moist.  The  greater  the  depression  of  the 
dew-point  below  the'  -^f  iary  or  shade  temperature,  the  less  the 
relative  humidity  ;  the  .iier  the  air,  the  i  lore  rapid  the  evaporation 
and  the  greater  the  consequent  reduction  of  temperature 


CLASSIFICATION  OF  CLIMATES.  63 

In  Washington,  Philadelphia,  or  San  Francisco,  where  the  moist- 
ure is  usually  abundant,  the  dew-point  is  generally  not  far  below 
the  shade-temperature,  evaporation  is  relatively  small,  and  hot 
weather  feels  hot.  On  the  other  hand,  at  Denver,  Santa  Fe,  or 
Prescott,  where  the  moisture  is  usually  scanty,  the  dew-point  is 
much  lower  than  the  shade-temperature,  especially  in  hot  weather, 
and  the  reduction  is  great — the  greater  the  higher  the  temperature.' 
This  is  true  of  all  arid  regions,  where  the  diiference  between  the 
dry  and  wet  bulbs  during  the  warmest  and  driest  portion  of  the 
day  will  range  from  20°  to  40°  F.  or  more. 

During  the  summer  the  extremes  of  heat  sometimes  felt  in 
Eastern  cities  are  almost  unbearable.  In  New  York,  for  instance, 
there  may  be  several  days  when  the  ordinary  shade-temperature 
reaches  over  90°  F.,  and  the  relative  humidity  may  be  80  to  85 
per  cent,  or  over,  which  means  that  the  difference  between  the  wet 
and  dry  bulbs  is  only  from  4°  to  9°  ;  that  is  to  say,  the  sensible 
temperature  is  81°  to  86°,  which  is  oppressive,  as  there  is  so  little 
evaporation.  With  an  ordinary  shade-temperature  of  90°  in  arid 
regions,  and  a  difference  of  30°  between  the  dry  and  wet  bulbs,  the 
relative  humidity  will  be  32  per  cent.  The  air  will  not  feel  hot 
because  the  sensible  temperature,  which  is  the  temperature  the 
body  endures,  will  be  but  60°,  and  the  dryness  in  the  air  insures 
rapid  evaporation. 

The  advantage  of  this  increased  evaporation  in  the  arid  country 
of  the  United  States  is  not  merely  theoretical.  It  is  very  real,  and 
makes  impressive  the  fact  that  88°  at  Charleston  and  88°  at  Santa 
Fe  are  two  different  things. 

To  convey  an  idea  of  the  distribution  of  such  temperatures.  Professor 
Harrington,  at  the  meeting  of  the  American  Climatological  Society  in 
1894,  exhibited  charts,  one  of  which  gave  the  normal  "  sensible  " 
or  wet-bulb  temperatures  for  the  month. of  July.  He  says:  ^'It  is 
an  instructive  chart,  and  clearly  shows  t  the  temperatures  which 
one  actually  feels  in  the  dry  West  and  Sou  hwest  are  decidedly  lower 
than  the  corresponding  temperatures  in         Eastern  States." 

A  '^  sensible  "  temperature-line  (wet  b  i  )  of  65°  F.  on  the  Massa- 
chusetts coast,  starting  inland  r4m  Bof  3,  goes  by  Albany,  up  to 
St.  Paul,  then  sweeps  in  a  w  .e  cur-  ittle  below  El  Paso  and 

passes  by  Tucson,  Phoenix,  Los  Angtch  h   '^d  San  Diego. 

J  Harrington  :  Transactions  of  the  American  Climalological  Association,  1894. 


64  MEDICAL  CLIMATOLOGY. 

The  July  sensible  temperature-line  of  60°  F.  starts  from  the  cool 
Maine  coast,  and  goes  almost  due  west  across  the  Great  Lakes  and 
near  Duluth  ;  then,  after  first  sweeping  up  to  Canada,  it  curves 
almost  southward  across  the  Dakotas,  western  Nebraska,  and  eastern 
Colorado,  until  it  turns  in  a  northwesterly  direction  near  Eddy  (N. 
M.),  and  passes  by  Silver  City  and  Prescott,  over  the  Sierra  Nevada 
to  Lake  Tahoe,  where  curving  first  to  the  southwest  it  then  returns 
through  the  San  Joaquin  Valley  and  by  Santa  Barbara  to  the  sea. 

The  sensible  temperature-line  of  55°  F.  starts  from  Medicine  Hat, 
in  Canada,  and  runs  a  little  east  of  south  over  the  mountain-ranges 
west  of  Denver,  turning  near  Santa  F6  to  go  west  by  Albuquerque, 
up  through  southern  and  western  Nevada  into  Northern  Califor- 
nia, and  then  into  the  Pacific  a  little  north  of  San  Francisco. 

This  chart  explains  the  comfortable  summers  which  are  usual 
throughout  a  great  portion  of  the  West.  It  shows  that  apparent 
high  temperatures  do  not  cause  the  prostration  and  discomfort  felt 
in  Eastern  cities. 

During  the  month  of  July  El  Paso  is  actually  more  comfortable 
than  Iowa,  and  the  vicinity  of  Denver  has  the  coolness  of  Canada 
near  the  Great  Lakes,  of  the  St.  Lawrence,  or  of  the  Maine  coast 
near  Mt.  Desert. 

Professor  Harrington  observes:  ''To  obtain  the  beneficial  effects 
of  the  reduction  of  temperature  by  ev^aporation  the  shade  must  be 
sought  and  the  direct  sun's  rays  avoided.  The  effects  may  be 
heightened  by  a  natural  or  artificial  breeze  or  wand,  and  for  parts 
of  the  body  covered  by  clothing  they  may  be  obtained  by  adapting 
the  clothing  to  the  free  passage  of  air  and  moisture.  For  hot 
weather,  and  in  the  shade,  the  color  of  the  clothing  is  of  less  con- 
sequence than  its  texture,  together  with  sufficient  looseness  to  permit 
of  the  free  access  of  air."' 

In  a  valuable  and  practical  paper  in  the  Denver  Republican  of 
January  1,  1896,  on  the  subject  of  sensible  temperature-readings 
and  their  importance  as  a  basis  in  judging  climate.  Captain  W.  A. 
Glassford,  U.  S.  A.,  spoke  very  forcibly  as  to  the  value  of  using  the 
readings  of  the  wet-bulb  thermometer.  The  ingeniously  arranged 
chart  which  accompanied  the  article  showed,  among  other  things, 
the  surprising  summer  coolness  of  the  country  south  of  Denver, 
running  into  the  middle  <si  New  Mexico  and  Arizona,  which  is  no 

1  Trans.  Amer.  Climatol.  Assoc,  vol.  x.  p.  373. 


CLASSIFICATION  OF  CLIMATES. 


65 


hotter  than  on  the  Canada-Hne  or  along  the  shores  of  the  Great 
Lakes  and  the  coast  of  Maine.  Captain  Glassford  has  kindly 
granted  permission  to  use  the  following  extract  from  his  table  : 

Tabular  statement  of  the  average  metallic  (or  ordinary  shade) 
temperature-record  and  the  sensible  temperature-record  with  their 
difference  at  selected  signal-service  stations  in  the  United  States 
for  the  months  of  July  and  January.  Compiled  by  Captain  W. 
A.  Glassford,  Signal  Service,  U.  S.  A.,  from  observations  taken  at 
7  A.M.,  3  P.M.,  and  11  p.m. 


July  temperature. 

January  temperature. 

Signal  Service  Stations. 

Metallic 
record. 

Sensible 
temp. 

Difference. 

Metallic 
record. 

Sensible 
temp. 

Difference. 

Atlantic  City,  N.  J.     .    .    . 

Baltimore,  Md 

Boston,  Mass 

Chicago,  111 

Denver,  Col 

Eastport,  Maine      .... 

El  Paso,  Texas 

Los  Angeles,  Cal     .... 

Nantucket,  Mass 

New  York  City,  N.  Y.     .    . 

Philadelphia.  Pa 

Prescott,  Arizona    .... 

St.  Louis,  Mo 

St.  Paul.  Minn 

Salt  Lake  City,  Utah  .    .    . 

San  Diego,  Cal 

San  Francisco,  Cal.     .    .    . 

Santa  Fe,  N.  M 

Washington,  D.  C 

Y'uma,  Arizona 

72.3°  F. 

76.5 

70.6 

70.6 

72.1 

60.6 

82.6 

70.0 

70.2 

72.9 

75.4 

72.5 

77.6 

70.2 

75  6 

67.5 

59.4 

68.8 

76.0 

91.1 

68.6°  F, 

68.6 

64.1 

64.3 

57.0 

56  7 

64.8 

63.0 

67.3 

66.6 

68.8 

59.5 

71.2 

64.0 

60.0 

62.9 

55.8 

55.9 

69.0 

75.0 

3.7°  F. 

7.9 

6.5 

6.3 
14.2 

3.9 
17.8 

7.0 

2.9 

6.3 

6.6 
13.0 

6.4 

6.2 
14.7 

4.6 

3.6 
12.9 

7.0 
16.1 

31.1°  F. 
32.4 
25.6 
20.7 
27.9 
21.2 
42.3 
53.0 
28.9 
28.4 
30.0 
34.0 
26.4 
7.4 
27.1 
53.7 
49.4 
26.3 
31.0 
52.8 

29.3°  F. 
30.9 
23.5 
19.1 
22.9 
19.5 
35  5 
47  0 
27.4 
26.7 
27.8 
29.5 
24.4 
6.4 
23.3 
48.9 
46.4 
22.6 
29.0 
45.3 

1.8°  F. 

1.5 

2.1 

1.6 

5.0 

1.7 

6.8 

6.0 

1.5 

1.7 

2.2 

4.5 

2.0 

1.0 

3.8 

4.8 

3.0 

3.7 

2.0 

7.5 

Winter.  When  the  frosty  nights  of  autumn  begin  to  merge  into 
the  sharper  cold  of  winter  the  invalid,  whose  thin  blood  and  low 
vitality  cause  him  to  dread  tlie  period  of  icy  blasts  and  snow,  begins 
to  think  of  the  warmth  and  sun  of  the  South. 

Besides  the  records  of  temperature,  other  important  essentials  in 
judging  of  a  climate  are  pure  air,  dry  soil,  pure  soft  water,  abun- 
dant sunshine,  moderate  rains,  and  satisfactory  accommodations 
and  food. 

Temperature  should  not  be  the  only  consideration. 

There  is  a  difference  in  the  value  of  similar  temperatures  in 
winter  and  summer. 

Where  very  equable  temperature  with  its  accompanying  moist  air 
is  not  desired,  a  valuable  index  of  the  amount  of  actual  humidity 
in  the  air  is  shown  by  the  "  absolute  humidity,"  which  is  computed 

5 


(J 6  MEDICAL  CLIMATOLOGY. 

by  the  number  of  grains  of  vapor  to  the  cubic  foot  at  the  tempera- 
ture and  relative  humidity  or  dew-point  given. 

The  amount  of  absolute  humidity  will  usually  indicate  the  feeling 
of  the  air,  which  in  a  very  moist  climate  may  be  chilly  at  56°, 
while  in  a  very  dry  climate  at  the  same  temperature  no  feeling  of 
chilliness  will  be  noticed. 

Heat  expands  the  air  and  raises  the  point  of  saturation.  The 
drier  the  air,  however,  the  more  rapid  is  the  evaporation  and,  there- 
fore, the  greater  is  the  feeling  of  coolness. 

On  the  other  hand,  cold  contracts  the  air,  the  vapor  is  taken  out 
of  it  by  condensation,  and  it  is  capable  of  holdiug  but  a  small 
amount  of  moisture  at  saturation,  the  capacity  decreasing  with  the 
temperature. 

Dry,  cold  air  is  stimulating,  producing  a  feeling  of  vigor  when 
the  temperature  is  not  too  low.  Of  course,  in  the  selection  of  a 
satisfactory  winter  climate  only  a  moderate  amount  of  cold  is  de- 
sirable. 

Another  reason  why  dry,  cold  air  does  not  feel  so  "  chilly  "  is 
that  the  conductibility  of  the  air  depends  on  its  moisture.  Cold  air 
is  necessarily  somewhat  dry,  and  the  body  does  not  (without  conduc- 
tion) readily  part  with  its  heat. 

A  bar  of  Iron  feels  colder  than  a  stick  of  dry  wood,  because  it  is 
a  better  conductor,  just  as  moist,  cold  air  is  a  better  conductor  than 
dry,  cold  air,  and  the  feeling  of  chilliness  produced  by  moist  air,  even 
when  it  is  only  moderately  cold,  is  well  known. 

The  temperature  of  the  air  for  either  summer  or  winter  should 
not  be  considered  independently  of  its  humidity,  as  cold,  dry  air  is 
as  essential  to  the  comfort  of  some  delicate  persons  in  winter  as  is 
warm,  dry  air  in  summer.  The  cause  of  this  is  not  difficult  of 
explanation.  It  has  already  been  stated  on  a  previous  page  that, 
with  a  low  humidity,  many  invalids  can  endure  comfortably  a  much 
lower  temperature  than  when  the  humidity  is  high. 

General  W.  H.  Greely,  in  an  article  in  Scribner^s  Magazine 
(November,  1888),  entitled '' Where  Shall  We  Spend  Our  Win- 
ter?" said  :  "  Next  in  importance  to  the  temperature  is  the  humidity 
of  the  air,  a  subject  to  which  the  public  does  not  generally  pay  due 
attention,  partly  through  inadvertence  and  partly  through  lack  of 
accessible  data.  .  .  .  While  at  all  times  sensations  of  dryness 
or  moisture  (and  in  summer  rapid  evaporatiou,^  which  lowers  tem- 

1  As  indicated  by  the  wet -bulb  thermometer. 


CLASSIFICATION  OF  CLIMATES.  67 

perature  and  promotes  comfort)  depend  largely  on  the  relative 
humidity,  yet,  during  the  winter  season,  the  absolute  humidity 
becomes  a  most  important  and  potent  factor  in  determining  the 
fitness  of  any  particular  climate  as  a  sanatorium."  Accompanying 
the  article  is  a  chart  prepared  by  General  Greely,  showing  the  con- 
dition of  absolute  humidity  for  tlie  United  States  for  the  month  of 
January  from  ten  years'  observations.  By  the  chart  the  least 
amount  of  absolute  humidity  is  seen  to  exist  in  the  extreme  cold 
of  Canada,  whence  it  goes  down  the  elevated  plains  to  southern 
New  Mexico,  east  and  west  of  which  the  humidity  increases  to  the 
coast.  On  the  Atlantic  coast  the  absolute  humidity  south  of 
Charleston  increases  steadily  from  3  grains  to  the  cubic  foot  of 
air  to  4  grains  a  little  south  of  Jacksonville  ;  5  grains  across  the 
Florida  peninsula  from  Tampa  to  Indian  E,iver ;  fi  grains  at 
Miami,  and  Q.Q  grains  at  Key  West.  Pensacola  and  New  Orleans 
have  about  3 J  grains ;  Galveston,  5|  grains :  San  Diego,  3^ 
grains.^ 

A  cold,  dry  atmosphere  will  be  found  near  the  Rocky  Mountains 
above  latitude  35°.  A  warm,  dry  atmosphere  is  found  in  western 
Texas,  southern  New  Mexico  and  Arizona,  and  southeastern  Cali- 
fornia. 

The  greatest  softness  and  mildness  of  climate  in  the  United  States 
are  found  along  the  California  coast,  where  General  Greely  says  the 
daily  variation  of  temperature  during  the  winter  months  scarcely  ex- 
ceeds 2°  F.  Arizona  and  the  interior  valleys  of  California  average 
8°,  as  do  the  Gulf  coast  and  Florida  south  of  St.  Augustine.  The 
rest  of  the  country  varies  from  4°  to  Q°,  increasing  toward  the 
Canadian  border ;  from  the  Gulf  coast  northward  the  variability 
increases  one  or  two  degrees  during  the  mouths  January  to  March. 

The  resources  of  the  United  States  in  the  matter  of  climate  are 
very  varied,  from  the  mountains,  lakes,  rivers,  and  elevated  plains 
along  the  Canadian  border  to  the  extreme  southern  limits  of  Florida 
and  Texas. 

In  spite  of  the  increasingly  good  work  of  the  Weather  Bureau, 
detailed  meteorological  reports  have  been  generally  meagre,  and  it 
must  be  many  years  before  all  of  the  attractiv^e  though  comparatively 
unknown  districts  of  the  country  can  be  brought  into  general  notice. 

The  best  climatic  advantages  of  the  Alps  can  be  found  iu  an  im- 

1  For  details  of  absolute  humidity,  see  Table  Vl. 


68  MEDICAL  CLIMATOLOGY. 

proved  form — because  available  all  the  year  rouud — in  the  ranges, 
valleys,  and  plains  of  the  Rocky  Mountains ;  similar  climatic  con- 
ditions to  those  of  Egypt  prevail  in  the  deserts  between  El  Paso 
(Texas)  aud  Palm  Springs  of  Mohave  (California)j  while  the  equa- 
ble climate  of  the  Riviera,  with  the  same  advantage  of  the  pro- 
tection afforded  by  the  mountains  above  the  coast,  with  a  smaller 
amount  of  annual  rainfall  and  less  discomfort  from  harsh,  cold  winds, 
is  to  be  found  in  Southern  California,  ,  Florida,  too,  offers  an  asylum 
for  winter  visitors,  especially  on  the  Atlantic  coast  at  St.  Augustine, 
and  southward  to  Lake  Worth;  while  Key  West  is  an  excellent 
example  of  a  warm,  equable,  and  very  moist  climate.  Unfortun- 
ately, there  are  no  complete  meteorological  records  relating  to  St, 
Augustine,  There  is,  however,  a  weather-station  at  Jupiter,  just 
south  of  latitude  27°,  where  there  is  a  lighthouse,  Jupiter  is  eight 
miles  north  of  the  upper  end  of  Lake  Worth,  on  which  is  the  new 
winter-resort  of  Palm  Beach. 

Among  interior  health-resorts  in  the  Southern  States,  Aiken, 
Thomasville,  aud  Asheville  have  many  advantages,  which  are 
referred  to  in  the  descriptions  of  those  places. 

In  that  portion  of  the  country  known  as  the  Great  Southwest, 
the  winter  climate  of  Colorado,  northern  New  Mexico,  and  Ari- 
zona may  be  characterized  in  a  phrase  as  eold,  dry  ;  that  of  New 
Mexico  and  Arizona  south  of  latitude  35°  as  warm,  dry  ;  and  that 
of  the  coast  of  Southern  California  (west  and  south  of  the  mountain- 
ranges)  as  warm,  moist. 

In  Colorado  during  the  winter  months  (December,  January,  Feb- 
ruary) the  day-temperature  on  the  plains  between  12  M.  and  2  p.m. 
averages  40°  or  45°  F.,  and  the  relative  humidity  at  the  same  time 
will  probably  range  between  30  and  35  per  cent,^ 

As  the  reported  daily  means  include  the  lowest  temperature  dur- 
ing the  twenty-four  hours,  the  extreme  cold  of  2  to  4  a.m.  greatly 
reduces  what  is  termed  the  mean  monthly  temperature,  which,  for 
Denver,  Colorado  Springs,  Pueblo,  and  Santa  Fe  (classifying  the 
latter  with  the  Colorado  climate),  is  about  30°  F. ,  with  a  mean  rela- 
tive humidity  of  54  per  cent,  and  a  winter  rainfall  of  from  one  to 
two  inches.  Caiion  City  has  about  the  same  mean  winter-tempera- 
ture, 34°,  but  is  more  sheltered  from  the  wind. 

A  resort  can  hardly  be  said  to  have  warm  winters  if  the  monthly 

1  See  comparison  of  Colorado  Springs  with  Gaudalajara  ;  also  description  of  the  climate  of 
Colorado. 


CLASSIFICATION  OF  CLIMATES.  69 

mean  temperature  for  that  season  is  less  than  45°  F.  It  need  not 
be  considered  a  disadvantage — especially  on  the  seacoast — if  it  is 
over  60°. 

AVe  see,  then,  that  to  get  the  benefit  of  greater  warmth  it  is 
necessary  to  go  south  of  latitude  35°. 

Arizona  affords  the  best  desert  climate  of  the  United  States,  and, 
as  winter-residences  for  health-seekers,  it  possesses  the  three  towns  of 
Tue<?on,  Phoenix,  and  Yuma.  As  the  entire  territory  of  Arizona  is 
west  of  the  great  Continental  Divide,  and  slopes  steadily  toward  the 
Pacific,  it  is  subject  to  a  certain  amount  of  ocean-influence — not  to 
the  extent  to  which  the  winter-rains  in  California  bear  witness,  but 
sufficiently  to  be  subject,  between  December  and  March,  to  occasional 
rains  or  snows  on  the  high  plateaus  and  on  the  southwest  slopes  of 
the  mountains.  There  are  few  cloudy  days  in  Arizona,  and  the 
spring  weather  is  usually  dry. 

The  greater  part  of  New  Mexico — about  four-fifths — is  situated 
east  of  the  Continental  Divide,  and  eujoys  almost  rainless  winters. 
It  has  also  a  dry  spring.  Colorado  also  has  little  rainfall  during 
the  winter,  but  it  is  one  of  the  disadvantages  of  the  climate  that  this 
cannot  be  said  of  the  spring.  The  normal  rainfall  at  Denver  and 
Colorado  Springs  for  the  two  mouths  of  April  and  May  is  4.8  inches 
and  4.6  inches  respectively  ;  while  for  both  El  Paso  aud  Phoenix  it 
is  less  than  one-half  an  inch  for  the  same  period. 

The  entire  country  south  from  Denver  and  then  west  in  a  wide 
curve  to  Los  Angeles  has  a  great  amount  of  sunshine,  and  on  the 
elevated  inland  plains  east  of  the  115th  degree  of  longitude  the  air 
is  cool,  balmy,  aud  very  dry. 

In  southern  Texas  a  warm,  moist  climate  is  found  at  San 
Antonio,  the  location  of  which  is  about  as  far  south  as  that  of  the 
city  of  Chihuahua  in  Mexico.  Chihuahua  has,  however,  a  much 
greater  altitude  and  a  climate  more  resembling  that  of  El  Paso. 

(For  details  of  winter  climates,  see  Tables  VI.  and  X.) 

Mexico  should  be  included  in  this  brief  review  of  winter  climates, 
as  that  country  has  practically  no  winter  rainfall,  while  there  are 
abundant  sunshine,  moderate  dryness,  and  a  temperature  about  the 
same  as  that  of  the  resorts  in  Southern  California  and  Florida  during 
the  same  period.  In  the  cities  on  the  great  Mexican  tableland  the 
nights  are  usually  cool  on  account  of  the  elevation. 

Going    south    from   Zacateoas    the  country   is    more   thoroughly 


70  MEDICAL  CLIMATOLOGY. 

cultivated,  the  cities  are  more  beautiful,  and  the  air  is  warmer  and 
more  humid.  The  plazas  and  gardens  have  a  greater  wealth  of 
verdure.  Even  the  patios  of  the  hotels  exhibit  more  plants  and 
flowers. 

Among  the  unpleasantnesses  associated  with  travelling  through 
Mexico  the  prevalence  of  fine  dust  is  an  annoyance  that  cannot  be 
avoided.  The  doubtful  quality  of  much  of  the  drinking-water  is  a 
matter  of  still  greater  importance,  and  in  most  of  the  Mexican  hotels 
proper  sanitary  arrangements  are  badly  neglected. 

The  seasonal  winter-temperature  for  a  few  Mexican  cities  is  as  fol- 
lows: Mexico,  54°  F. ;  Guadalajara,  60°;  Monterey,  55°;  Durango, 
50°;  Zacatecas,  55°;  Aguas  Calientes,  57°;  San  Luis  Potosi,  57°; 
Queretaro,  59°. 


SECTION  11. 


INTRODUCTION. 


This  section  treats  broadly  of  the  ailments  to  which  climatic  treat- 
ment is  applicable  or  for  which  it  is  commonly  used,  and  of  the 
way  in  which  the  values  of  climates  and  meteorological  factors  in- 
fluence them,  each  group  of  diseases  being  considered  in  turn. 
Change  of  air  is  rarely  indicated  in  acute  affections,  but  very  fre- 
quently in  convalescence  and  in  chronic  disorders.  Phthisis  being  by 
far  the  most  important  of  such  diseases,  is  first  considered,  and  is 
treated  at  greater  length  and  more  elaborately  than  other  chronic  affec- 
tions. Much  concerning  the  effects  of  climate  upon  this  disease  is, 
however,  applicable  more  or  less  to  certain  of  the  other  maladies,  and 
can  be  studied  witli  advantage  in  such  connection,  as  it  has  not 
seemed  best  to  extend  the  length  of  the  treatise  by  repeating  these 
points  so  fully  under  the  head  of  each  separate  disease. 

As  has  been  stated  in  the  general  introduction,  particular  climates 
are  not  recommended  for  particular  diseases — in  short,  no  ready- 
made  prescriptions  are  given  ;  but  if  the  different  sections  of  the 
book  are  studied  together,  a  climate  can  be  chosen  for  an  invalid  upon 
rational  grounds ;  and  although  the  results  may  not  be  entirely  suc- 
cessful, owing  to  individual  peculiarities  in  the  patient,  to  unex- 
pected or  untoward  circumstances  in  his  private  affairs,  to  the  preva- 
lence of  unusually  bad  weather  in  the  chosen  resort,  or  to  some 
change  for  the  worse  in  the  accommodations  provided  for  invalids, 
yet  the  physician  will  have  the  satisfaction  of  feeling  that  he  has  at 
least,  so  far  as  the  data  allowed,  used  the  scientific  in  place  of  the 
customary  empirical  method  in  selecting  a  climate,  and  has,  conse- 
quently, done  something  toward  putting  medical  climatology  abreast 
of  the  other  branches  of  scientific  medicine,  behind  which  it  has 
lingered  for  so  long. 


72  MEDICAL  CLIMATOLOGY. 

It  is  very  much  to  be  regretted  that  so  few  physicians  have 
reported  the  results  of  climatic  treatment  upon  their  patients, 
particularly  in  phthisis,  though  a  careful  search  through  the  litera- 
ture enabled  me  to  find  reports  which  together  reached  a  total  of 
over  eight  thousand  cases,  and  these  have  been  tabulated  and  con- 
sidered in  the  chapter  on  Phthisis. 


CHAPTER  VI. 

PHTHISIS. 

Definition  and  Nature  of  Phthisis.  What  is  phthisis  ?  This 
terra  is  simply  a  Greek  word  for  wasting,  and  it  is  literally  the  same 
as  consnmption.  It  is  applied  to  chronic  lung-disease  which  is  ac- 
companied by  progressive  emaciation.  Since  Koch's  discovery  of  the 
tubercle-bacillus  it  has  been  found  that,  with  very  few  exceptions, 
chronic  diseases  of  the  lungs  in  which  there  is  a  tendency  to  a  con- 
suming of  the  body-streugth  and  substance  are  tuberculous  in  origiu, 
although,  after  the  tuberculous  process  is  arrested,  the  fibrosis — that 
is,  the  change  of  the  kiug-substance  into  fibrous  tissue  generally  pro- 
voked by  the  resistance  of  the  luug  to  the  irritation  of  the  tubercle — 
may  go  on  and  cause  death  by  destroyiug  the  elasticity  and  interfer- 
ing with  the  blood-supply  of  the  lung. 

Cases  of  phthisis  without  tuberculosis,  or  those  in  which  the 
tubercle-bacillus  cannot  be  discovered,  are'doubtless  inmost  iustances 
caused  by  some  other  micro-organism.  These  non-tuberculous  cases 
are  comparatively  few  in  number,  and,  when  once  established,  tend 
to  run  along  lines  similar  to  the  tuberculous  cases.  During  their 
course  they  all  exhibit  fibrosis;  but  this,  instead  of  being  provoked  by 
the  bacillus,  is  caused  by  the  inhaling  of  some  irritating  substance, 
such  as  the  dust  arising  in  the  manufacture  of  grindstones,  emery- 
powder,  etc.,  by  previous  repeated  or  extensive  inflammations  of 
the  luug-tissue  or  bronchial  tubes,  or  by  special  poisons,  such  as 
syphilis  or  cancer. 

As  such  cases  are  very  similar  to  the  true  tuberculous  cases,  it 
will  suffice  for  the  purposes  of  this  inquiry  to  limit  the  meaning  of 
the  term  phthisis  to  that  which  is  accompanied  by  pulmonary  tuber- 
culosis. 

Phthisis  may  then  be  defined  as  a  disease  of  the  lungs,  occa- 
sionally acute  throughout  its  entire  course,  but  usually  chronic,  or, 
at  least,  tending  to  become  so  soon  after  its  inception.  It  is 
dependent,  as  its  primary  source  of  irritation,  upon  the  presence 
of  the  tubercle-bacillus,  which,  being  deposited  either  in  the  lung- 


74  MEDICAL  CLIMATOLOGY. 

tissue  or  in  the  air-cells,  or  in  the  bronchial  tubes  leading  thereto, 
produces  a  low  form  of  inflammation,  provided  that  the  tissue  in 
which  it  has  secured  lodgement  is  susceptible  to  its  influence — i.e., 
that  it  contains  the  food  upon  which  the  bacillus  is  nourished. 
This  inflammation  is  called  tuberculosis,  because  of  the  tubercles — 
minute,  rounded  bodies,  composed  of  bacilli,  which  have  become 
surrounded  by  a  mass  of  degenerated  lymph.  These  tubercles 
may  be  either  grouped  or  scattered,  and  sooner  or  later  they  almost 
invariably  give  rise  to  an  irritation  and  consequent  inflammation 
of  the  structures  in  which  they  are  imbedded.  The  irritation 
thus  set  up  usually  results  iu  consolidation  of  the  affected  tissue, 
which  is  thereby  rendered  impervious  to  air  and  therefore  use- 
less. This  is  the  first  stage  of  phthisis,  and  this  condition  may 
endure  for  a  long  time,  or  it  may,  on  the  contrary,  be  cleared  up 
by  reabsorption  into  the  circulation.  Again,  the  diseased  tissue 
may  become  fibrosed  and  shrink  up  like  a  scar,  or  it  begins,  per- 
haps, to  ulcerate,  a  condition  which  indicates  that  the  second  stage 
of  phthisis  has  been  reached.  At  this  point  it  occasionally  happens 
that  the  lung  clears  up  entirely,  the  arrest  of  the  disease  being 
effected  iu  one  or  both  of  two  ways:  either  a  partial  discharge  of 
the  tubercles  takes  place  through  expectoration,  or  the  ulcerations 
dry  up,  and  the  tubercles,  after  losing  their  moisture,  contract  into 
calcareous  mases,  the  surrounding  tissue  becoming  fibrosed.  Other- 
wise the  ulcerations  break  down  en  masse,  and  the  debris  is  expelled 
by  expectoration,  leaving  cavities  surrounded  by  a  wall  of  tissue, 
chiefly  fibroid  in  character.  This  condition  constitutes  the  third  stage 
of  phthisis.  By  this  process  the  bulk  of  the  affected  portion  of  the 
lung  may  be  eliminated  and  the  further  spread  of  the  disease  be 
limited  by  the  cavity-wall.  These  cavities  themselves  may  in  time 
heal  and  contract,  or,  after  remaining  quiescent  for  a  period,  they 
may  finally  break  through  the  wall  and  extend;  or  the  secretion  from 
them  may,  without  the  breaking  down  of  the  wall,  be  carried  to  the 
healthy  portions  even  of  the  opposite  lung,  in  any  of  which  events 
new  foci  or  centres  of  disease  originate  without  direct  contact  be- 
tween the  diseased  and  healthy  tissues.  Again,  the  purulent  matter 
may  be  absorbed  into  the  blood  and  cause  pyaemia — that  is,  a  poison- 
ing of  the  system  by  the  carrying  through  the  bloodvessels  of  blood 
impregnated  with  pus. 

During  these  various  morbid  processes  there  is   almost  always 
more  or  less  loss  of   flesh  and   strength,   frequently  accompanied 


PHTHISIS.  75 

by  fever,  uight-svveats,  and,  in  50  per  cent,  of  the  cases,  by  slight  or 
severe  bleeding.  In  many  of  these  stages,  but  especially  in  the 
third,  the  fibroid  process  is  the  method  whereby  the  healthy  lung  is 
protected  from  the  further  encroachment  of  the  disease,  and  what 
remains  is  encapsulated.  Fibrosis,  although  primarily  a  benevolent 
process,  sometimes  becomes  a  malignant  one,  because,  when  its 
extent  is  considerable,  it  renders  the  lung  so  inelastic  that  breathing 
cannot  be  carried  on  efficiently  ;  thus  the  pulmonary  circulation  is 
interfered  with  and  body  and  strength  waste  from  lack  of  suffi- 
cient oxygenation  and  healthy  blood. 

Tuberculosis.  Tuberculosis  is  an  infective  disease,  dependent 
upon  the  growth  of  tubercles  in  living  tissue,  a  tubercle  being  a 
minute  body  composed  of  degenerated  lymph  surrounding  a  microbe 
called  the  tubercle-bacillus,  as  has  been  before  stated. 

It  is  the  general,  and  probably  the  correct,  belief  that  tuberculosis 
ectnnot  exist  without  the  bacillus  ;'  but  it  is  possible  and  indeed  prob- 
able that  the  bacillus  can  and  occasionally  does  exist  in  the  body 
without  tuberculosis — that  is,  without  becoming  the  centre  of  a 
globule  of  peculiarly  degenerated  lymph,  and  so  forming  a  tubercle 
and  causing  tuberculosis.  Bacilli  have  been  found  in  the  air-pas- 
sages and  in  other  parts  of  the  body,  although  there  was  no  tubercu- 
losis, and  no  irriiation  or  disease  had  so  far  been  induced  by  their 
presence.  Sir  Hugh  Beevor  has  shown  that  the  tubercle-bacillus,, 
which  is  a  vegetable  growth,  will  develop  outside  of  the  body  at' 
ordinary  temperatures  in  Europe,  and  he  states  that  it  occasionally 
appears  as  a  saprophyte.  It  would  therefore  seem  as  if  the  tubercle- 
bacillus,  and  indeed  the  other  micro-organisms  which  always  accom- 
pany special  diseases,  such,  for  instance,  as  typhoid  and  diphtheria, 
must  be  brought  into  connection  with  degenerated  lymph  or  some 
decomposed  matter  in  order  to  become  virulent  and  infective."     In 

1  Though  cases  of  a  supposed  pseudo-tuherculosis  have  been  described  as  occurring  very 
occasionallj-,  but  what  germ,  if  any  (other  than  the  bacillus)  is  the  cause,  has  not  yet  been 
discovered. 

2  With  reference  to  the  influence  of  environment  and  food  upon  the  virulence  of  germs,  the 
following  extract  from  a  paper  by  Dr.  G.  Sims  Woodhead,  upon  "  The  Relation  of  the  Morbid 
Conditions  Dependent  on,  or  Associated  with,  the  Presence  of  Streptococci,"  will  be  found 
pertinent : 

"  It  is  evident  from  the  wide  distribution  of  streptococci  under  normal  conditions,  and  from 
the  great  variety  of  the  disease-processes  with  which  it  is  to  be  found  associated  : 

"1.  That  it  must  itself  undergo  great  modifications  as  regards  its  power  of  growing  and  of 
forming  its  special  pus  or  inflammation-producing  products. 

"2.  That  it  is  so  frequently  found  associated  with  other  organisms  in  widely  different  condi- 
tions that  the  modifications  mentioned  under  1  may  well  be  due  in  part  at  least  to  its  symbiotic 
existence. 

"3.  That  it  produces  even  when  present  in  pus,  say.  as  a  pure  culture,  such  very  different 


76  MEDICAL  CLIMATOLOGY. 

the  case  of  the  tubercle-bacillus  it  is  the  degenerated  mass  plus  the 
bacillus  which  constitutes  a  tubercle  ;  and  a  tubercle,  and  not  the 
bacillus  alone,  is  necessary  to  cause  tuberculosis. 

It  is  true,  then,  that  the  tubercle-bacillus  may  occasionally  be 
present  in  living  tissue  without  causing  irritation,  and  when  found 
in  small  numbers  it  can  readily  be  destroyed  by  some  element  of 
the  blood  or  tissue.  Just  what  this  element  is  is  as  yet  uncertain. 
Moreover,  these  bacilli  die  or  are  consigned  temporarily  or  per- 
manently to  a  state  of  innocuous  desuetude  when  they  become  sur- 
rounded by  a  protective  envelope  of  hardened  exudation,  and  in 
this  condition  they  may  lie  dormant  till  called  into  destructive 
activity  by  an  inflammation  of  the  tissue  in  which  they  are  im- 
bedded. This  fact  probably  accounts  for  many  of  the  tubercular 
joint-aifections  following  an  injury ;  for  in  these  cases  nests  of 
bacilli,  apparently  of  long  standing,  are  often  found.  In  regard 
to  this  question  of  latent  tuberculosis  the  extract  given  below  is 
interesting.^     When  ulcerative    processes    arise  in  conuection  with 

degrees  of  reaction,  when  inoculated  into  different  species  of  animals,  and  animals  in  various 
states  of  health,  that  the  state  of  the  tissues  themselves  must  play  a  most  important  part  in 
determining  the  life-history  and  functional  activity  of  the  parasitic  organism. 

"  We  now  know  that  even  outside  the  body  a  virulent  streptococcus  may  rapidly  lose  its 
pathogenic  power,  and  it  is  only  hy  exercising  the  greatest  care,  by  growing  it  in  serum- 
bouillon,  and  then  passing  the  organism  through  rabbits  from  time  to  time,  that  this  patho- 
genic activity  can  be  exalted  or  even  maintained.  The  exaltation  of  virulence  that  has  been 
obtained  from  comparatively  harmless  streptococci  by  using  Marmorek's  method  is,  however, 
so  remarkable,  that  the  discrepancies  observed  by  earlier  workers  at  once  become  explicable, 
on  the  theory  that  the  same  organism  may  at  different  times  adapt  itself  to  a  saprophytic  mode 
of  life  on  the  one  hand,  or,  as  the  conditions  under  which  it  exists  become  gradually  altered,  to 
a  parasitic  mode. 

"It  is  evident,  of  course,  that  during  the  saprophytic  life  the  activity  of  the  organism  be- 
comes diverted  along  the  lines  most  favorable  to  the  reproduction  of  its  species  in  large  numbers, 
as  the  agents  inimical  to  its  existence  are  comparatively  few  and  of  a  different  kind  from  tiiose 
with  which  it  has  to  contend  during  its  parasitic  existence.  It  leads,  therefore,  what  may  be 
called  a  vegetative  life,  devoting  its  energies  to  reproduction  and  to  withstanding  the  action 
of  light  and  similar  destructive  agents 

"During  its  parasitic  existence,  on  the  other  hand,  the  organism  is  waging  warfare  for  its 
very  existence  ;  in  its  new  surroundings,  with  the  different  food  now  at  its  disposal  (proteids 
of  various  kinds),  and  contending  against  living  cells,  much  of  its  vegetative  activity  is 
diverted  to  the  production  of  substances  which  will  exert  a  paralyzing  influence  on  the  living 
tissues.  The  streptococcus  is  living,  as  it  were,  at  a  higher  level,  and  is  forming  substances 
which  in  its  merely  vegetative  existence  it  is  incapable  of  producing. 

"  We  must  not  assume  from  this  that  the  micro-organism  is  still  capable  of  going  back  sud- 
denly to  its  saprophytic  existence,  and  of  at  once  reproducing  its  progeny  as  rapidly  as  before. 
This  is  not  the  case ;  the  streptococcus  does  not  grow  so  easily  outside  the  body  as  before,  and 
it  is  only  as  the  higher,  or  toxin-forming,  function  becomes  modified  that  the  power  of  vegeta- 
tion returns  in  full  tovcQ."— London  Medical  Journal,  October  3,  1896. 

'  "It  is  a  well-known  fact,  long  observed,  that  tuberculous  lesions  are  often  found  after 
death  when  their  existence  during  life  had  not  attracted  especial  attention  or  had  even  escaped 
observation.  So  well  established  is  this  fact  that  the  Germans  have  adopted  an  axiom  that 
every  one  ultimately  becomes  infected  with  tuberculosis.  The  multiplication  of  the  tubercle- 
bacilli  and  the  generation  of  toxins  occasion  only  local  effects  until  the  intensity  of  the  process 


PHTHISIS.  77 

tuberculosis  the  local  destruction  or  death  that  follows  would  appear 
to  be  due  immediately  at  least  to  what  is  termed  mixed  infection — 
that  is,  to  some  of  the  other  micro-organisms,  such  as  the  various 
forms  of  the  streptococci  which  accompany  the  inflammation,  and 
these  micro-organisms  flourish  because  of  certain  defects  in  the 
tissues  or  blood  of  the  individual.  Such  defects  may  be  of  a  tempo- 
rary or  a  permanent  character,  and  are  generally  found  in  conjunc- 
tion with  the  presence  of  the  tubercle-bacilli,  but  always  with  some 
form  of  inflammation  or  catarrh.  On  the  other  hand,  it  would  appear 
that  when  the  bacilli  are  absorbed  or  inoculated  in  vast  numbers  the 
phagocytes,  or  other  germicidal  elements  of  the  blood  or  tissues,  are 
overwhelmed,  and  bacillary  tuberculosis  is  implanted  over  a  con- 
siderable area  near  the  point  of  entrance.  It  may  be  limited  to  this 
area,  at  least  for  a  time,  if  the  individual  attacked  has  the  ability  to 
rally  and  to  set  up  a  wall  of  defensive  lymph  ;  but  if  such  indi- 
vidual have  special  susceptibility,  enlarged  lymph-spaces,  or  other 
peculiarity  characteristic  of  the  tuberculous  or  scrofulous  diathesis, 
which   is   commonly   inherited,  and   if  he  be  also  without  efficient 

has  reached  such  a  degree  that  the  resulting  products  gain  entrance  into  the  circulation  and 
thus  give  rise  to  constitutional  manifestations. 

"  Maragliano,  in  an  address  recently  delivered,  discusses  the  question  of  latent  and  larval 
tuberculosis  and  offers  a  number  of  interesting  and  valuable  considerations  bearing  upon  that 
subject.  When  tuberculosis  is  present  without  subjective  or  objective  symptoms,  he  goes  on 
to  say,  the  latency  may  pursue  one  of  three  courses :  (a)  it  may  persist  indefinitely  ;  (b)  it  may 
be  limited  in  duration  ;  or  (c)  it  may  be  intermittent  in  occurrence.  When  the  latency  is  per- 
sistent the  infection  is  beyond  the  range  of  certain  detection,  the  processes  of  autotherapy  or 
autoserum therapy  sufficing  to  control  the  advance  of  the  disease.  Late  in  the  history  of  the 
case  there  may  be  some  impairment  of  resonance,  in  consequence  of  the  presence  of  new-formed 
cicatricial  connective  tissue.  When  the  latency  is  limited  in  duration  the  infection — for  a 
variable  period  not  manifest — suddenly  makes  its  appearance.  In  this  group  belong  cases  in 
which,  without  previous  symptoms,  hsemoptysis  occurs  ;  also  those  in  which  manifestations  of 
tuberculosis  make  iheir  appearance  in  connection  with  some  acute  infectious  process.  The 
duration  of  this  limited  latency  is  variable  and  uncertain.  The  translation  from  latent  to 
manifest  tuberculosis  may  be  viewed  as  an  evidence  of  increased  intensity  of  infection  or  of 
diminished  bodily  resistance,  or  perhaps  a  combination  of  the  two.  The  developed  disease 
may  ta)  progress,  (b)  remain  stationary,  or  (c)  subside,  perhaps  permanently,  perhaps  to  recur. 

"Larval  tuberculosis  is  that  in  which  typical  manifestations  of  infiltration  are  wanting, 
although  other  symptoms  of  the  infection  are  present.  This  type  of  the  disease  may  appear  in 
one  of  two  forms ;  (1)  dystrophic,  (2)  typhoid.  The  first  is  characterized  by  progressive  disturb- 
ance of  nutrition.  The  patient  gradually  fails,  anaemia  develops,  the  heart  becomes  enfeebled 
and  the  pulse  rapid,  the  appetite  is  lost  and  the  digestion  impaired,  debility  ensues,  and 
mental  depression  results.  As  a  rule,  there  is  an  absence  of  fever,  and  physical  signs  may 
appear  only  late.  The  typhoid  form  of  larval  tuberculosis  is  from  the  beginning  attended 
with  fever,  to  which  derangements  of  innervation  are  early  added.  The  fever  is  at  first  inter- 
mittent, later  becoming  remittent  or  subcontinuous.  The  general  strength  may  be  maintained. 
Exacerbations  closely  resembling  attacks  of  typhoid  fever  are  repeated  from  time  to  time.  In 
some  cases  both  types  of  the  disease  may  be  present. 

"  The  manifestatious  of  larval  tuberculosis  are  to  be  attributed  to  intoxication  with  the  pro- 
ducts of  bacterial  activity,  and  vary  as  one  or  other  poison  predominates.  The  symptoms  of 
tuberculosis  may  be  masked,  whatever  the  localization  of  the  lesion  ;  but  this  is  most  often  the 
case  when  the  lungs  and  the  lymphatic  glands  are  involved." — Medical  Record,  July  11,  1896. 


78  MEDICAL  CLIMATOLOGY. 

power  to  build  a  wall,  the  bacilli  will  be  carried  all  through  the 
organ,  and  through  the  entire  body  unless  the  system  too  quickly 
succumbs.  The  experiments  of  Trudeau  showed  that  when  guinea- 
pigs  were  inoculated  with  moderate  doses  of  bacillary  matter  and 
kept  under  good  hygienic  conditions  the  bacilli  would  disappear 
entirely  or  the  consequent  tuberculosis  would  be  limited.  Large 
doses,  however,  produced  general  tuberculosis,  proving  that  even  in 
healthy  persons  the  absorption  of  great  quantities  of  bacillary  matter 
can  cause  general  tuberculosis,  tiiough  it  doubtless  occurs  oftenest 
in  those  who  have  a  special  susceptibility. 

Tuberculosis  is  usually  followed  by  phthisis,  but  not  necessarily 
so.  If  the  tissue  which  is  inoculated  with  the  bacilli  is  not  sus- 
ceptible and  is  healthy,  the  tuberculosis  does  not  spread,  and  in  due 
course  the  bacilli  are  killed  and  eliminated  ;  but  if,  as  has  been  said, 
a  very  large  amount  be  introduced,  the  infection  will  spread  even 
through  healthy  tissues,  and  will  destroy  life  by  affecting  the  organ 
or  organs  attacked  so  that  they  cannot  carry  on  their  functions. 
This  process  is  known  as  acute  infective  tuberculosis. 

Thus,  in  recapitulating,  we  may  fairly  assume  from  experimental 
and  other  good  evidence  that  the  following  statements  are  true  : 

1.  That  phthisis  and  tuberculosis,  while  usually  allied,  are  not 
the  same  thing. 

2.  That  phthisis  may  exist  without  tuberculosis. 

3.  That  tuberculosis  may  exist  without  phthisis ;  but  it  is  prob- 
able that  all  forms  of  phthisis  are  dependent  for  their  essential  char- 
acteristics upon  the  development  of  a  neoplasm  resembling  true 
tuberculosis.  By  true  tuberculosis  is  meant  the  common  form  of 
the  disease— that  which  is  always  connected  with  the  presence  of 
the  special  micro-organism  known  as  the  tubercle  bacillus  of  Koch. 
In  cases  of  real  or  apparent  tuberculosis  in  which  Koch's  bacilli 
are  not  found  it  may  be  that  the  bacilli  have  become  destroyed  or 
eliminated,  or  they  may  not  be  in  a  condition  to  take  the  stain  and 
so  become  visible  under  the  microscope,  or  perhaps  such  cases  are 
caused  by  some  micro-organism  other  than  Koch's  bacillus.^ 

1  This  at  present  is  mere  speculation,  but  it  would  explain  the  cause  of  the  difference  of 
opinion  between  those  bacteriologists  who  contend  that  there  is  no  tuberculosis  without  the 
Koch  bacillus,  visible  or  invisible,  and  such  eminent  clinicians  as  the  late  Sir  Andrew  Clark, 
who  believed  in  the  occasional  existence  of  phthisis  independently  of  bacillary  tuberculosis. 
The  ulcerative  processes  of  all  cases  of  phthisis  are  always  accompanied  by  the  presence  of 
destructive  and  irritating  micro-organisms  other  than  the  tubercle-bacillus,  such  as  the  cocci 
of  pus,  etc.  It  is  readily  conceivable  that,  in  a  person  of  depraved  health,  a  chronic  inflam- 
mation of  pulmonary  tissue,  arising  from  one  of  many  causes,  such  as  a  simple  inflammation 


PHTHISIS.  79 

4.  Phthisis  is  a  destructive  lung-process  attended  by  a  general 
wasting  of  the  body  ;  it  is  dependent  for  its  progress  upon  the 
irritation  set  up  by  the  intrusion  of  some  foreign  substance  into 
the  respiratory  organs,  and  is  modified  in  its  character  by  the  resist- 
ance of  the  individual.  Such  resistance  may  be  too  feeble  to  hinder 
the  increase  of  the  irritation,  or  it  may  be  so  energetic  as  to  be 
locally  destructive,  the  effect  in  either  case  being  eventually  to  further 
the  disease.  Of  the  several  causes,  bacillary  tuberculosis  is  so  much 
the  most  common  that  it  is  rare  to  find  a  case  of  phthisis  which 
has  originated  in  any  other  way. 

5.  Tuberculosis  is  an  infective  disease  dependent  upon  the  deposit 
of  tubercle  in  the  lungs  or  other  organs ;  it  is  usually  but  not  always 
followed  by  phthisis. 

6.  A  tubercle  is  a  minute,  rounded  body  composed  of  a  specific 
germ,  the  tubercle-bacillus,  surrounded  by  a  mass  of  degenerated 
lymph  ;  a  tubercle  cannot  arise  without  the  bacillus,  though  the 
bacillus  may  later  disappear  from  tuberculous  masses,  or  at  least 
may  not  be  discoverable  by  the  usual  tests. 

7^  The  tubercle-bacillus  is  found  occasionally  without  the  sur- 
rounding tuberculous  mass,  and  it  is  apparently  unable  to  produce 
the  phenomena  of  tuberculosis  while  in  this  condition.  Further, 
it  may  be  accepted  as  proved  that,  in  the  laboratory,  progressive 
and  fatal  tuberculosis  can  be  produced  in  healthy  animals  even 
while  they  are  under  good  hygienic  conditions,  provided  that 
they  are  inoculated  with  a  sufficiently  large  amount  of  tuberculous 
matter. 

Causes  of  Phthisis.  In  man  it  is  doubtful  if  tuberculosis  is  ever 
established  unless  there  be  some  lesions  of  the  membranes  to  form 
an  entering-point,  and  usually  a  lowering  of  the  normal  resisting- 
power  also.  For  this  reason  it  is  rare  to  find  tuberculosis  running 
its  course  without  the  consequent  existence  of  more  or  less  phthisis. 
On  the  other  hand,  cases  of  phthisis  which  have  not  resulted  from 
tuberculosis  are  few  compared  with  those  in  which  tuberculosis  is  the 
primary  cause,  and  of  this  limited  number  not  many  are  free  from 
tuberculosis  during  their  entire  course.  It  is  therefore  best,  in  order 
to  avoid  confusion,  to  discuss  phthisis  in  connection  with  climate 
as  if  it  were  always  tuberculous. 

or  one  of  the  dust-diseases,  may  form  a  soil  for  the  Jodgement  of  some  destructive  micro-organ- 
ism other  than  the  tubercle-bacillus,  which  surrounds  itself  with  an  envelope  similar  to  that 
of  true  tuberculosis.  Osier,  in  the  second  edition  of  his  Practice  of  Medicine  (page  215),  in  giving 
a  lucid  and  succinct  description  of  the  formation  of  the  tubercle,  says  that,  in  the  initial 
stages,  it  does  not  differ  from  certain  other  inflammatory  processes. 


80  MEDICAL  CLIMATOLOGY. 

Prevalence  of  Phthisis.  In  considering  the  causes  of  the  preva- 
lence of  phthisis  the  prominent  points  appear  as  follows: 

1.  It  is  a  germ-disease,  and  therefore  is  most  prevalent  in  densely 
populated  cities  and  populous  countries,  where  infection  is  naturally 
rife. 

2.  As  the  disease  can  be  acquired  only  by  inhalation  of  the  bacilli 
from  the  dust  of  the  dried  sputum,  by  the  consumption  of  food  and 
drink  which  have  been  contaminated  by  tuberculous  matter,  by  direct 
contact  of  bacillary  material  with  abraded  surfaces  or  by  direct  in- 
heritance, and  as  the  life  of  the  bacillus  is  very  brief  when  it  is  ex- 
posed to  pure  air  and  sunlight,  it  follows  that  where  the  air  is  impure 
phthisis  is  most  common. 

3.  As  tuberculosis  may  be  directly  transmitted  from  the  parent 
to  the  child  (although  more  commonly  merely  a  susceptibility  is  in- 
herited), phthisis  is  most  frequent  among  the  oldest-established  races. 
Viewed,  therefore,  in  its  character  as  a  germ-disease,  it  is  not  sur- 
prising that  the  researches  of  Hirsch,  Lombard,  Copland,  Woeikof, 
Weber,  and  others  have  demonstrated  that  phthisis  is  least  frequent 
among  those  who  dwell  on  mountains  or  on  open  and  comparatively 
uninhabited  plains,  and  that  it  is  relatively  rare  in  the  following 
order :  on  certain  seacoasts,  on  certain  islands  enjoying  an  ocean 
climate  as  nearly  pure  as  possible,  in  certain  desert-places  of  consid- 
erable extent — such  as  the  great  American  and  African  deserts  and 
the  steppes  of  Tartary — in  the  polar  regions,  and,  finally,  at  ele- 
vations, the  rarity  of  the  disease  increasing  with  the  altitude. 

Having  considered  phthisis  apart  from  the  direct  influence  of 
climate,  and  shown  that  as  a  germ-disease  with  a  certain  limited 
power  of  contagion  it  can  establish  itself  under  favorable  condi- 
tions in  any  climate,  we  will  pass  to  a  consideration  of  the  climatic 
factors  which  influence  its  development  and  progress. 

The  Various  Climatic  Factors  -which  Affect  the  Prevalence 
of  Phthisis.  Pure  Air.  The  experiments  of  Brown-S6quard, 
Stokes,  Trudeau,  and  others  show  that  when  animals  which  have 
been  successfully  inoculated  with  bacillary  matter  are  kept  in  con- 
fined spaces  with  imperfect  ventilation  they  become  tuberculous, 
while  those  which,  after  similar  inoculations,  are  kept  in  open-air 
quarters  escape  the  disease.  This  goes  to  prove  that  the  presence 
of  pure  air  not  only  makes  infection  from  the  bacilli  less  likely,  but 
that  even  when  they  are  received  through  inoculation  or  otherwise  it 
aids  the  body's  natural  resistance  and  promotes  recovery.     There- 


PHTHISIS.  81 

fore,  the  first  essential  of  a  climate  for  a  consumptive  is  pure  air, 
because  it  assists  to  a  cure  and  lessens  the  dangers  from  infection. 
This  is  why  the  risk  of  the  spread  of  disease  from  the  assembling  of 
large  numbers  of  consumptives  in  health-resorts,  where  the  air  is 
pure,  is  very  much  less  than  in  the  cities  whence  they  came,  pro- 
vided cleanliness  and  ventilation  of  the  dwellings  are  not  neglected. 
The  danger  is  always  greater  in  the  cars,  streets,  alleys,  hotels,  and 
houses  of  cities  than  in  country  towns  and  open  places,  even  if 
similar  unclean  conditions  prevail,  for  it  is  possible  for  the  bacillus 
to  maintain  its  virulence  outside  the  body  only  in  dirty,  ill-ventilated 
holes  and  corners. 

Sunlight.  Next  in  importance  to  pure  air  is  sunlight.  Where 
sunlight  is  abundant,  pure  air  must  be  present.  Its  power  to  nullify 
or  to  mitigate  the  results  of  unsanitary  conditions  is  shown  in  the 
healthiness  of  the  air  in  such  sunny  climates  as  Tangier,  where, 
although  much  foulness  and  filth  lie  rotting  in  the  streets,  an  in- 
valid who  avoids  impure  water,  admits  the  sun  and  air  to  his  apart- 
ments, and  lives  a  healthy  life,  often  derives  benefit  in  spite  of  the 
lack  of  sanitation.  The  power  of  sunlight  to  purify  water,  as  shown 
later,  accounts  no  doubt  for  the  comparative  lack  of  odor  and  harm- 
lessness  of  the  open  sewers  which  extend  through  the  centres  of  the 
streets  in  old  European  and  Oriental  cities.  The  power  of  sunlight 
to  destroy  the  life  of  the  tubercle-bacillus  and  other  bacteria  has  been 
demonstrated  by  numerous  experiments.  In  direct  sunlight  a  few 
minutes  suffice  to  kill  them  ;  and  if  air  which  has  been  sunned  is  ad- 
mitted to  apartments  infected  by  bacillary  sputum,  they  may  be  safely 
occupied  at  the  end  of  three  to  five  wrecks,  especially  if  the  bedding, 
carpets,  and  hangings  have  been  taken  out  and  exposed  to  sunlight. 

"The  credit  of  first  bringing  to  notice  the  fact  that  direct  sun- 
light kills  or  stops  the  growth  and  action  of  bacteria  is,  so  far  as 
known,  due  to  Dr.  A.  Downes  and  Mr.  Thomas  P.  Blunt,  who, 
in  1877,  communicated  to  the  Royal  Society  of  London  their  re- 
searches on  the  effects  of  light  upon  these  micro-organisms." 

The  results  of  their  numerous  experiments  are  stated  by  them  as 
follows  : 

"  1.  Light  is  inimical  to  the  development  of  bacteria  and  the 
microscopic  fungi  associated  with  putrefaction  and  decay,  its  action  on 
the  latter  organisms  being  apparently  less  rapid  than  on  the  former. 

"  2.  Under  favorable  conditions  it  wholly  prevents  that  develop- 
ment, but  under  less  favorable  it  may  only  retard. 

6 


82  MEDICAL  CLIMATOLOGY. 

"3.  The  preservative  quality  of  light,  as  might  be  expected,  is 
most  powerful  in  the  direct  solar  rays,  but  it  can  be  demonstrated 
to  exist  in  ordinary  diffused  daylight. 

''4.  So  far  as  our  investigation  has  gone  it  would  appear  that  it 
is  chiefly  but  perhaps  not  entirely  associated  with  the  actinic  rays  of 
the  spectrum. 

"  5.  The  fitness  of  the  culture-liquid  to  act  as  a  nidus  is  not  im- 
paired by  insolation. 

''  6.  The  germs  originally  present  in  such  liquid  may  be  wholly 
destroyed  and  a  putrescible  fluid  perfectly  preserved  by  the  uuaided 
action  of  light." 

Downes  aud  Blunt  noticed  also  that  the  germicidal  action  of  light 
was  held  in  abeyance  when  the  experiments  were  performed  in 
vacuo . 

The  general  retarding  and  destructive  influence  of  suulight  upon 
bacteria  has  since  been  verified  by  many  other  investigators. 

Tynrlall  confirmed  the  fact  that  light  restrained  the  develop- 
ment, but  failed  to  fiud  that  it  impaired  the  vitality  of  bacteria. 
About  ten  years  ago  Duclaux  experimented  with  pure  cultures  of 
several  different  bacteria,  and  found  that  after  direct  exposure  to 
sunlight  their  spores  failed  to  germinate.  Airlong  and  Momont 
have  proved  by  their  independent  researches  that  the  moist  spores 
of  authrax-bacilli  are  incapable  of  development  after  an  exposure  of 
two  hours  to  the  direct  solar  rays,  and  Momont  has  also  demon- 
strated that  sunlight  has  no  effect  on  these  spores  if  air  be  ex- 
cluded. 

Kooh,  in  an  address  delivered  before  the  International  Medical 
Congress  at  Berlin  in  1(S90,  stated  that  tubercle-bacilli  were  killed 
by  an  exposure  to  direct  sunlight  varying  in  length  from  a  few  min- 
utes to  several  hours,  the  time  depending  upon  the  thickness  of 
the  layer  exposed.  He  also  stated  that  tubercle-bacilji  were  destroyed 
in  from  six  to  seven  days  by  exposure  to  ordinary  diffuse  daylight, 
such  as  is  found  near  windows  in  fairly  lighted  houses. 

In  1892  Geisler  observed  that  the  development  of  the  typhoid 
bacillus  was  retarded  by  insolation,  and  recent  investigations,  con- 
ducted by  Billings  and  Peckham,  have  shown  that  the  typhoid 
bacillus  is  destroyed  by  a  direct  insolation  of  from  three  to  six 
hours. 

Buchner  and  Minck,  in  studying  the  influence  of  light  upon 
various  bacteria  suspended  in  water,  the  bacilli  of  typhus  and  of 


PHTHISIS.  33 

cholera  being  among  the  number,  found  that  sunlight  exercised  a 
powerful  germicidal  action.  Water  containing  10,000  germs  to  the 
cubic  centimetre  showed  no  living  germs  at  all  after  an  hour's  direct 
insolation,  while  a  control-specimen  kept  in  the  dark  at  the  same 
temperature  showed  a  slight  increase  in  the  number  of  bacteria. 
These  investigators  deduce  from  their  experiments  that  sunlight 
must  be  considered  one  of  the  important  factors  in  the  auto-disin- 
fection of  rivers  and  lakes,  and  for  this  reason  they  consider  the 
exposure  of  these  sources  of  public  water-supply  to  sunlight  of  great 
sanitary  importance. 

Though  the  results  obtained  by  numerous  other  investigators 
might  be  cited  as  cumulative  evidence,  yet  enough  has  probably 
been  adduced  to  establish  the  value  of  sunlight  as  "  one  of  the  most 
potent  and  one  of  the  cheapest  agents  for  the  destruction  of  patho- 
genic bacteria,  and  that  its  use  for  this  purpose  is  to  be  remembered 
in  making  practical  hygienic  recommendations,"^  and  also  to  show 
that  "  the  popular  idea  that  the  exposure  of  articles  of  clothing  and 
bedding  to  the  sun  is  a  very  useful  sanitary  precaution  is  fully  sus- 
tained by  the  experimental  data  relating  to  the  action  of  heat, 
desiccation,  and  sunlight." 

The  same  data  have  likewise  emphasized  two  important  limita- 
tions of  the  germicidal  power  of  sunlight:  first,  that  its  destruc- 
tive activity  extends  but  little  beyond  the  surface  of  opaque  bodies, 
such  as  soil,  clothing,  and  the  like,  and  that  its  power  gradually 
decreases  with  the  increasing  thickness  or  depth  of  transparent 
bodies,  as  water  and  glass ;  and,  secondly,  that  the  presence  of  oxy- 
gen is  essential  for  its  activity. 

Apparently  the  germicidal  action  of  light  is  chiefly  due  to  a  direct 
oxidation  of  the  micro-organisms  accomplished  at  low  temperatures, 
the  oxygen  being  stimulated  to  activity  by  the  presence  of  light 
probably  in  much  the  same  manner  as  occurs  in  photography.  But 
there  is  also  another  effect  of  light  that  may  play  a  not  inconsider- 
able part  in  certain  cases.  Recent  experiments  of  Roux  and  others 
show  that  the  conclusion  of  Downes  and  Blunt,  that  light  did  not 
affect  the  fitness  of  culture-liquids  as  nidi,  is  not  true  in  all  in- 
stances, and  that  light  docs  in  some  cases  modify  and  change  either 
the  physical  or  chemic  state  of  the  culture-fluids  so  that  the  bacteria- 
growth  is  considerably  restrained,  and  in  some  instances  is  incapable 
of  taking  place  at  all."^ 

1  Sternberg's  Bacteriology,  p.  154. 

2  Climate  and  Health,  No.  3,  p.  62  (Weather  Bureau,  Washington). 


84  MEDICAL  CLIMATOLOGY. 

It  has  been  suggested  that  perhaps  the  Rdntgeu  rays  may  be 
used  to  destroy  micro-organisms,  such  as  the  baciUus  tuberculosis, 
in  the  living  body  through  the  germicidal  properties  of  the  violet 
rays. 

Apart  from  the  direct  destructive  effects  of  fresh  air  upon  the 
germs,  its  indirect  effect,  through  supplying  a  pure  food  to  the 
lungs,  the  chief  seat  of  the  disease,  is  most  important,  as  without  this 
no  improvement  can  take  place.  Thus,  by  assisting  the  healthy 
working  of  the  lungs  it  increases  their  power  of  resistance  as  well  as 
that  of  the  blood.  Sunlight,  as  has  been  said  in  the  chapter  on 
Physiology,  also  exerts  a  powerful "  beneficial  influence  upon  the 
body,  promoting  healthy  growth  and  increased  oxidation  of  tissue, 
and  revivifying  and  gently  stimulating  the  mental  and  nervous 
systems. 

Sun-heat.  An  adjunct  to  the  direct  sanitary  eff^ects  of  sunlight 
is  sun-heat,  when  not  too  intense  or  prolonged.  Its  direct  physio- 
logical effects  are  to  iucrease  growth,  to  lessen  the  amount  of  food 
needed,  and  to  diminish  muscular  force.  An  important  indirect 
effect  of  sun-heat  is  to  induce  patients  to  live  more  out  of  doors, 
and  to  keep  their  doors  and  windows  open. 

Temperature.  The  indirect  effects  of  the  sun's  heat  in  raising 
the  temperature  of  the  air  must  be  considered  independently.  It 
does  not  follow  that  a  climate  must  be  hot  because  it  has  abundant 
sunshine;  the  heat  may  be  great  under  the  direct  rays  of  the  sun, 
and  the  air,  if  its  humidity  be  low,  may  yet  remain  cool,  for  air 
only  receives  and  holds  heat  through  the  watery  vapor  which  it 
contains.  In  regard  to  the  question  as  to  whether  consumption  is 
most  prevalent  in  hot  or  cold  climates,  it  must  be  remembered  that 
the  important  point  is  not  the  degree  of  heat  or  cold  possessed  by  a 
climate,  but  the  amount  of  its  humidity. 

Humidity  of  the  Soil.  The  influence  of  a  damp  soil  upon  phthisis 
has  been  proved  by  Bowditch,  Buchanan,  Milroy,  Pepper,  and 
many  others  to  be  even  worse  than  that  of  damp  air,  hot  or  cold. 

Humidity  of  the  Air.  It  is  found  that,  other  conditions  being 
equal,  consumption  is  most  prevalent  in  climates  in  proportion  to 
the  temperature  and  humidity  as  follows:  first  come  damp,  cold 
climates;  second,  damp,  hot  climates;  third,  dry,  hot  climates; 
and,  fourth,  dry,  cold  climates;  and,  in  promoting  recovery  from 
consumption,  as  a  broad  statement  the  reverse  order  holds  good. 
Thus,  in  a  general  way,  it  may  be  said  that  dampness  is  harmful  to 


PHTHISIS.  85 

the  consumptive  and  dryness  beneficial,  while  the  relative  effects 
of  heat  and  cold  depend  upon  the  humidity.  Therefore,  in  a  damp 
climate  heat,  except  when  tropical,  is  less  harmful  than  cold;  while 
in  a  dry  climate  cold,  on  the  contrary,  is  more  beneficial  than  heat — 
that  is,  to  the  vital  resistance,  though  not  always  to  the  disease. 

The  fact  that  damp,  cold  climates  (such  as  the  winter  climates  of 
New  England  and  the  Great  Lake  region,  and  of  the  British  Isles) 
are  more  harmful  to  the  consumptive  than  damp,  warm  ones  (such 
as  the  winter  climates  of  Florida  and  Madeira)  is  not  so  apparent 
as  it  should  be,  partly  because  reports  of  consumptive  cases  are 
not  sufficiently  abundant,  and  partly  because,  consumption  being  a 
germ-disease  and  undeniably  much  influenced  by  density  of  popu- 
lation and  unhygienic  conditions,  more  is  laid  to  these  causes  than 
in  any  way  belongs  to  them.  Nevertheless,  statistics  and  the  reports 
of  observers  confirm  this  statement.  At  the  same  time,  while  the 
disease  arises  more  frequently  in  cold,  damp  climates,  it  runs  a  more 
rapid  and  fatal  course  in  hot,  damp  ones.  Hirsch  demonstrated  that, 
while  damp  heat  is  not  shown  to  have  a  positive  influence  on  the 
production  of  consumption,  it  has  a  decidedly  unfavorable  one  upon 
its  progress  when  once  established.  He  also  proves,  as  do  others, 
that  damp  cold  is  a  positive  factor  in  the  production  of  phthisis 
and  is  highly  injurious  to  those  in  whom  the  disease  is  developed. 

Apparently  humidity  of  the  air,  apart  from  other  factors,  does  not 
in  itself  produce  phthisis;  the  comparative  immunity  from  consump- 
tion among  the  men  of  the  British  navy  contrasted  with  those  of  the 
army,  and  the  rarity  of  the  disease  in  many  islands,  such  as  the 
Faroe,  the  Shetlands,  the  Hebrides,  and  Iceland,  show  this.  The 
influence  of  these  climates  and  of  sea-voyages  on  the  disease  when 
developed  and  active  has,  however,  not  been  shown  by  the  evidence 
of  others  nor  by  my  own  observation  to  be  advantageous,  removal 
from  the  sea  being  generally  of  most  benefit.  Where  advantage  has 
been  derived  from  a  sea  climate  it  would  appear  probable  that  it 
was  owing  to  the  great  purity  of  the  air  or  the  elimination  of  un- 
sanitary conditions  and  hurtful  occupations,  as  when,  for  instance, 
an  overworked  citizen  takes  a  sea-voyage,  or  a  Bostonian  is  sent  to 
such  a  climate  as  that  of  the  Isles  of  Shoals,  or  a  Philadelphian  to 
Atlantic  City."  Therefore,  it  is  fair  to  assume  that  when  a  humid 
climate,  apart  from  other  climatic  factors,  proves  beneficial  to 
phthisis  it  is  purely  negative  in  its  action.  This  does  not,  how- 
ever, prevent  the  possibility  of  its  being  of  positive  benefit  in  the 


86  MEDICAL  CLIMATOLOGY. 

exceptional  cases  of  phthisis  iu  Avhich  the  accompanying  conditions 
of  the  circulation,  nervous  system,  or  mucous  membranes  demand 
a  damp  climate  for  their  relief. 

Dryness  of  the  air,  on  the  contrary,  is  known  to  be  of  positive 
beneiit  to  the  consumptive.  The  excellent  results  obtained  froiji 
desert-air  (apart  from  great  altitude,  which  will  be  considered  later) 
are  too  well  known  to  quote  at  length.  The  l^enefit  derived  on  the 
steppes  of  Tartary  is  often  mentioned,  and  I  have  myself  noted 
while  on  the  spot,  and  also  in  patients  I  have  sent  there,  remark- 
able results  produced  by  the  climate  of  Upper  Egypt  and  by  that  of 
Arizona  and  of  the  Mojave  Desert,  lying  behind  the  littoral  of  South- 
ern California.  Some  years  ago,  while  practising  iu  London,  I  also 
observed  in  several  cases  of  consumption  which  were  tending  to 
deteriorate  great  improvement  iu  the  general  and  local  signs  of 
phthisis  after  they  had  been  employed  for  several  months  as 
shampooers  iu  the  Turkish  baths,  where  they  lived  for  most  of  the 
twenty-four  hours  in  a  very  dry  and  superheated  air.  That  the 
dryness  and  not  the  heat  was  the  cause  of  the  improvement  may  be 
fairly  inferred  from  the  fact  that  hot,  moisi  climates  are  not  bene- 
ficial; and  I  may  add  that  from  inquiries  I  have  made  in  Egypt 
and  elsewhere  where  the  so-called  Russian  and  hot  vapor-baths  are 
in  vogue,  I  find  that  consumptives  are  very  properly  warned  against 
their  use. 

In  crediting  dryness  of  air  per  se  with  a  beneficial  influence  upon 
phthisis  we  must  not  forget  that  some  share  of  the  credit  at  least 
belongs  to  the  other  necessary  accompanying  factors  of  a  dry  atmos- 
phere, namely,  more  powerful  sunlight  and  heat,  less  depressing 
cloudy  weather,  cooler  nights  and  shade,  and  a  higher  electric  ten- 
sion of  the  body.  "What  is  also  of  prime  importance  is  the  greater 
opportunity  for  exercising  and  resting  iu  the  open  air,  and  the  free 
access  of  fresh  air  to  the  house  by  day  and  by  night  while  an  invalid 
is  indoors.^ 

With  respect  to  the  rarity  of  phthisis  in  dry,  low  climates,  Hirsch 
writes  as  follows  :  "  There  are  few  countries  of  the  w^orld  so  charac- 
terized by  uniformity  of  temperature  and  comparative  dryness  of 
the  air  as  the  inland  districts  of  Low^er  Egypt  and  tlie  valley  of  the 
Xile  in  Central  and  Upper  Egypt — regions  in  which  phthisis, accord- 
ing to  all  observers,  is  very  uncommon.     On  the  other  hand,  as  we 

1  Author's  article  upon  Climate.    Hare's  System  of  Therapeutics. 


PHTHISIS.  87 

have  already  seen,  localities  on  the  coast,  such  as  Alexandria, 
Damiett,  and  Port  Said,  with  a  moist  climate  and  a  great  range 
of  temperature,  are  much  more  subject  to  the  disease.  Tiie  same 
relation  between  the  sort  of  climate  and  the  number  of  cases  is 
found  in  the  interior  districts  of  Algiers,  on  the  one  part,  and  the 
coast-belt  of  that  country,  on  the  other.  In  India,  says  Hunter, 
the  localities  specially  distinguished  by  dryness  of  climate  (and 
uniformity  of  temperature),  be  they  on  the  plains  or  among  the 
hills,  are  least  affected  by  phthisis ;  and  the  same  relationship  may 
be  discovered  in  Java,  in  the  Gulf  States  of  the  American  Union, 
in  Mexico,  in  Guiana,  and  in  many  of  the  West  Indies.  It  is  a 
probable  conjecture  that  the  way  in  which  the  climate  affects  the 
amount  of  disease  is  through  the  particular  states  of  the  weather 
(high  degree  of  atmospheric  moisture  along  with  great  variations 
of  the  thermometer),  causing  catarrhal  affections  of  the  mucous 
membrane  and  the  after-effects  of  the  same,  that  the  climatic  in- 
fluence, accordingly,  is  in  all  probability  a  predisposing  factor  in 
the  development  of  phthisis.  It  is  from  the  same  point  of  view 
that  we  may  explain  the  beneficial  effects  of  the  climatic  treatment 
of  consumption — a  treatment  which  consists  in  withdrawing  the 
subjects  of  phthisis  or  those  who  are  threatened  with  phthisis  from 
these  harmful  climatic  influences.'" 

Variability.  Severe  and  sudden  changes  of  temperature  from 
day  to  day  have  no  more  determining  influence  ^er  se  than  has  the 
absolute  height  of  the  temperature.  Hirsch  refers  to  the  evidence 
furnished  in  abundance  from  numerous  places  in  the  more  elevated 
regions  of  North  and  South  America,  where  the  disease  is  rare, 
although  these  districts  are  subject  to  very  extreme  fluctuations  in 
temperature.  The  evidence  shows  that  variability,  with  dryness  of 
air,  has  at  least  no  prejudicial  influence  on  phthisis,  except,  of 
course,  in  some  special  cases ;  and  there  are  many  theoretical  rea- 
sons, and  I  believe  good,  practical  ones  also,  as  will  be  shown  later, 
for  believing  these  qualities  to  be  beneficial. 

Hirsch  has  shown  that  variability,  with  dampness  of  air,  when 
conjoined  with  frequent  oscillations  of  temperature,  predisposes  to 
phthisis  ;  while,  on  the  other  hand,  damp  heat  has  been  shown  not 
to  have  a  positive  influence  in  its  production,  but  a  decidedly  un- 
favorable one  upon  its  progress  when  once  established,  doubtless 
because  it  favors  the  growth  of  the  germ. 

1  Hirsch  :  Handbook  of  Geographical  and  Historical  Pathology,  vol.  ii. 


88  MEDICAL  CLIMATOLOGY. 

Density  of  Population.  In  studying  the  causes  of  the  geograph- 
ical distribution  of  phthisis  it  is  found  that  density  of  population 
stands  out  most  prominently  and  constantly  in  connection  with  a 
high  death-rate  from  phthisis.  The  reasons  for  this  would  appear 
to  be  chiefly  increased  danger  of  infection  and  increased  impurity  of 
air.  The  fact  that  the  death-rate  has  been  lowered  in  cities  after 
sanitary  improvements  have  been  carried  out  confirms  this  opinion. 
The  wide  distribution  of  phthisis,  even  in  localities  where  the  cli- 
mate itself  is  inimical  to  the  disease,  shows  that  man's  neglect  of 
sanitation  can  render  futile  all  natural  safeguards. 

Unhealthy  Occupation.  The  next  important  cause  seems  to  be 
unhealthy  occupation,  particularly  if  attended  with  inhalation  of 
irritating  dust  or  fibre,  as  in  knife-grinding  and  wool-sorting. 
With  few  exceptions  indoor  occupations  are,  for  obvious  reasons 
(such  as  confinement,  impure  air,  etc.),  more  injurious  than  outdoor 
ones;  but  among  indoor  occupations,  where  other  conditions  are 
similar,  those  which  necessitate  a  cramped  position,  thus  interfering 
with  the  free  expansion  of  the  chest,  increase  the  percentage  of 
phthisis. 

Dampness  of  soil  probably  ranks  next  as  a  predisposing  cause 
of  phthisis.  Observations  made  by  various  specialists  in  different 
countries,  beginning  with  the  work  of  Bowditch  in  New  England, 
and  followed  by  that  of  Buchanan  in  Great  Britain  and  Pepper  in 
Pennsylvania,  have  established  its  injurious  influence. 

Variability  of  temperature,  with  moisture,  should  perhaps  fol- 
low next,  especially  wiien  the  temperature  is  low;  for  instance,  in  a 
damp  climate  variability  is  always  greater  in  winter  than  in  summer. 
Old  and  New  England  are  notable  examples,  being  countries  where 
consumptives  can  often  reside  during  the  summer  without  harm, 
whereas  it  is  always  more  or  less  dangerous  for  them  to  remain  in 
such  climates  through  the  winter.  The  death-rate  from  phthisis  is 
also  much  higher  in  winter ;  but,  as  there  are  so  many  other  causes 
operating  to  bring  about  this  result,  the  evidence  of  mortality  is  not 
so  important  as  that  of  morbidity. 

Variability  of  temperature,  with  dryness,  on  the  other  hand, 
seems  to  lessen  the  death-rate  from  phthisis  both  in  warm  and  cold 
weather  ;  for  while  the  death-rate  is  I  '<>-her  in  wiuter  than  in  summer 
in  dry,  variable  climates  as  well  as  ;  .  in^^ist,  variable  ones,  yet  the 
winter  death-rate  of  the  dry  is  much  less  thai,  hat  of  the  moist  climate 
(The  prqbab'  •  <?- uses  of  the  higher  winter-rate  will  be  discussed  else- 


PHTHISIS.  89 

where.)  In  deserts  and  on  open  plains  and  mountain-sides  variability 
of  temperature  with  dryness  is  exhibited  in  the  change  of  tempera- 
ture from  day  to  night  and  from  sunlight  to  shade,  and,  in  most  of 
them,  in  much  wind  ;  yet  it  is  in  these  places  that  phthisis  is  rare, 
the  death-rate  low,  and,  among  the  consumptives  resorting  to  them, 
the  improvement  is  greatest.  Further,  in  these  climates  the  majority 
of  patients  improve  more  in  the  dry,  variable  cold  of  winter  than  in 
the  dry,  variable  warmth  of  summer.  Dr.  Hermann  Weber  said 
in  his  Letsommian  Lectures:  "  Many  people  still  cling  to  the  idea 
that  cold  is  injurious  and  warmth  curative  in  phthisis,  but  this  idea 
is  quite  incorrect.  Another  idea  that  equable  climates  are  the  best 
in  the  treatment  of  phthisis  should  likewise  be  much  restricted.  The 
most  important  point  of  all  good  climates  for  phthisis  is  purity  of 
air.  This  is  to  be  found,  first,  in  elev^ated  regions,  second  in  the 
desert,  and  third  on  the  sea  " 

Mobility  of  Atmosphere.  It  is  extremely  difficult  to  general- 
ize upon  the  influence  of  this  meteorological  factor  on  the  develop- 
ment or  progress  of  phthisis.  As  wind  is  usually  associated  with 
increase  of  heat  and  cold,  dryness  or  dampness^  its  effects  must 
be  estimated  in  connection  with  them.  Thus,  a  cold  wind  is 
more  severe  than  still  cold  ;  an  extremely  hot,  dry  wind,  such  as 
the  sirocco  or  khamsin,  is  more  irritating  and  trying  than  still  heat 
of  the  same  temperature ;  and  a  cold,  damp  wind  is  more  depressing 
and  dangerous  than  still,  damp  cold.  On  the  other  hand,  with 
moderate  warmth,  either  damp  or  dry,  a  breeze,  though  not  directly 
stimulating,  is  refreshing  on  account  of  its  causing  increased  evapo- 
ration from  the  skin,  even  when  the  actual  temperature  of  the  air  is 
not  lowered.  This  is  shown  by  the  relief  afforded  by  the  use  of 
punkahs  and  fans.  With  moderate  cold  a  breeze  is  usually  stimii- 
lating  whether  it  be  damp  or  dry.  It  may  be  said  that,  given  cer- 
tain conditions  of  the  air  with  respect  to  temperature  and  humidity, 
a  wind  which  is  not  greatly  different  from  the  atmosphere  in  these 
respects  increases  the  previous  stimulating  or  depressing  qualities  of 
the  air  of  the  place  in  which  it  blows.  As  a  matter  of  fact,  the 
temperature  and  humidity  of  the  wind  are  usually  different  from 
those  of  the  atmosphere  of  the  place  to  which  it  comes,  and  this 
difference  and  the  difference- 'h  the  conditions  of  the  evaporation 
from  the  lungs  and  skin  co  wiilch  it  gives  rise  form  the  dominant 

-iaracteristics  of  a  cliniL.e.' 

-  Wind  maybe  said,  broadly  speaking,  to  make  a  h\  I  cfima  e  worse 


90  MEDICAL  CLIMATOLOGY. 

and  a  good  one  better  with  these  qualifications  :  that  even  in  a  bad 
climate  the  wind  commonly  acts  beneficially  as  a  scavenger  and 
purifier,  and  as  a  whip  to  sluggishness,  and  in  hot  weather  it  is 
more  or  less  refreshing.  While  it  may  perform  these  same  func- 
tions with  like  advantage  in  a  good  climate,  it  may  also  blow  too 
strongly  and  stir  up  dust  and  restrict  outdoor  life,  or  it  may  prove 
too  stimulating  and  so  become  irritating.  When  we  find  many  con- 
sumptives doing  equally  as  well  in  good  climates  that  are  windy  as 
in  good  climates  that  are  calm  we  cannot  say  that  wind,  per  se,  is 
good  or  l)ad.  We  may  say,  however,  that  wind  increases  or  de- 
creases the  climatic  characteristics  of  a  resort,  and  sometimes  trans- 
ports to  it,  for  the  time  being,  a  totally  different  climate. 

Consumption  is  neither  more  nor  less  prevalent  in  a  place  simply 
because  it  is  windy,  nor  are  consumptives  as  a  class  made  better  or 
worse  by  this  element  alone.  It  is  beneficial  or  detrimental  accord- 
ing to  its  temperature  and  humidity  and  the  patieut's  condition — 
that  is,  according  to  his  need  of  stimulation  or  sedation. 

Cold,  moist  wind  sometimes  soothes,  but  more  often  depresses 
the  patient,  while  it  aggravates  catarrhal  affections  if  they  be  of  a 
relaxed  type. 

Cold,  dry  air  simply  stimulates  or  else  irritates  the  patient,  and 
hence  it  improves  relaxed  catarrhal  conditions  but  makes  those 
which  are  inflammatory  worse. 

Warm,  moist  wind  lessens  irritability,  and  is  either  soothing  or 
depressing. 

Warm,  dry  wind  acts  as  a  tonic  or  increases  irritability. 

Types  of  Climate  as  Distinguished  by  their  Temperature 
and  Humidity.  In  considering  the  influence  of  temperature  as  a 
cause  of  the  prevalence  of  phthisis  the  degree  of  heat  or  cold  is 
important.  Taking  extreme  climates,  the  polar  regions  are  cer- 
tainly freer  from  phthisis  than  the  tropics,  and  transported  con- 
sumptives (at  least  those  who,  possessing  a  good  physique,  are  in 
an  early  stage  of  the  disease)  do  better  in  arctic  than  in  tropical 
climates;  while  in  resident  consumptives  the  disease,  as  has  been 
stated,  is  much  more  rapid  and  fatal  in  tropical  tlian  in  arctic 
regions.  In  the  European  arctic  zone  phthisis  is  very  rare  ;  but 
this  is  not  true  to  the  same  extent  in  that  of  the  Western  hemis- 
phere, apparently  because  the  traders  hav^e  done  more  to  introduce 
among  the  natives  rum,  syphilis,  and  the  evils  which  too  often 
accompany  civilization.     How  far  the  difference  in  absolute  humidity 


PHTHISIS.  91 

is  a  cause  cannot  be  clearly  determined,  though  it  is  thought  by 
the  best  authorities  to  be  of  much  importance;  but  as  the  evidence 
strongly  shows  that  phthisis  develops  and  flourishes  less  in  dry  than 
in  damp  air,  this  is  a  reasonable  explanation  of  the  fact  that  tropical 
heat  is  worse  than  arctic  cold  for  phthisis.  As  has  been  shown 
in  the  chapter  on  Physics,  the  capacity  of  cold  air  for  holding 
moisture  is  extremely  limited.  Therefore,  the  absolute  humidity 
is  necessarily  low  in  arctic  climates,  while  as  the  capacity  of  the 
air  for  holding  moisture  increases  rapidly  with  increased  tem- 
perature, it  follows  that  in  tropical  climates  the  absolute  humidity 
is  necessarily  high — as  a  matter  of  fact,  it  is  usually  very  high 
indeed. 

AVith  regard  to  moderately  cool  and  moderately  warm  climates,  it 
would  appear  that  phthisis  is  more  prevalent  and  progressive  in 
moderately  cool,  moist  climates  than  in  moderately  warm,  moist 
climates.  As  an  illustration,  phthisis  is  more  prevalent  in  Eng- 
land than  in  Italy,  in  Germany  than  on  the  Riviera,  in  New  Eng- 
land than  in  Southern  California.^ 

In  contrasting  moderately  cool,  dry  and  moderately  warm,  dry 
climates  it  is  not  easy  to  say  that  one  is  better  than  the  other,  since 
in  both  phthisis  is  infrequent,  rarely  progressive,  and  generally 
tends  to  recovery.  Climates  which  are  moderately  cool  and  decid- 
edly dry  can  be  said  to  exist  in  the  United  States  only  at  eleva- 
tions over  4000  feet  and  above  latitude  35°,  and  climates  which  are 
moderately  cool  but  only  relatively  dry  may  be  found  at  elevations 
between  1000  feet  and  4000  feet.  Of  the  former  class  Colorado, 
during  the  summer  and  on  most  winter-days,  is  an  example, 
although  an  opinion  based  upon  the  rigor  of  its  winter-night 
and  its  shade-temperatures  would  place  it  among  cold,  dry  climates. 
Of  the  latter  class — i.e.,  moderately  cool,  relatively  dry  climates — 
Bethlehem,  in  the  White  Mountains,  is  an  average  example;  but 
it  should  be  remembered  that,  during  the  winter  season,  such 
climates  as  this  are  cold,  and  not  at  all  dry.  Moderately  warm, 
dry  winter  climates  are  found  in  Egypt,  at  varying  elevations  in 
parts  of  New  and  old  Mexico,  and  in  Arizona. 

Depressed  Climates.     Increased  barometric  pressure,  as  a  thera- 

1  Examples  of  moderately  cool,  moist  climates  are  found  in  the  summer  on  the  North  Atlantic 
coast  of  the  United  States,  in  the  woods  of  Maine,  the  forests  of  the  Adirondacks,  and  in  the 
British  Isles.  In  the  winter  season  such  places  as  the  coast-resorts  of  Southern  California, 
the  Riviera,  Thomasville,  parts  of  Florida,  and  Madeira,  while  they  vary  in  degree,  are  aU 
examples  of  moderately  warm,  moist  climates. 


92  MEDICAL  CLIMATOLOGY. 

peutic  agent,  enters  verv  little  into  the  domain  of  climatology,  and 
is  chiefly  of  concern  in  contrast  to  its  opposite — decreased  baro- 
metric pressure.  There  are,  however,  some  few  places  where,  owing 
to  depression  of  the  earth's  surface  below  sea-level,  the  influence  of 
increased  barometric  pressure  is  felt, and  these  will  be  discussed  under 
the  head  of  depressed  climates  as  distinguished  from  elevated  climates. 
Under  this  head  are  classed  the  climates  of  those  places  which 
are  below  the  level  of  the  sea.  They  exhibit  more  or  less  of  the 
phenomena  of  increased  barometric  pressure,  the  physical  and 
physiological  effects  of  which  have  been  discussed  in  the  chapters 
on  Physics  and  Physiology. 

Places  of  any  considerable  depth  below  sea-level  are  not  numerous, 
and  none  of  them  have  been  fully  and  scientifically  studied  with  re- 
spect to  their  physiologic  and  therapeutic  influence,  but  it  may  be 
said  that  phthisis  is  not  prevalent  in  any  of  them.     The  surface  of 
the  Dead  Sea  in  Palestine,  according  to  Lieutenant  Dale,  is  1316.7 
feet  below  the  level  of  the  Mediterranean,  while  Lieutenant  Symonds 
found  the  greatest  depth  of  its  waters  was  1350  feet.     This  makes 
the  bottom  of  the  Dead  Sea  2666.7  feet  below  the  surface  of  the 
Mediterranean.     It  is,  therefore,  so  far  as  is    known,  the  deepest 
fissure  in  the  earth's  surface.    It  has  been  stated  that  residence  upon 
its  shores  has  brought  relief  to  chronic  bronchitics  and  asthmatics, 
and  that  a  sanitarium  is  to  be  erected  for  their  accommodation. 
Lake  Assai,  in  the  Afar  country  of  Africa,  is  760  feet  below  sea- 
level,  and  there  are  said  to  be  other  depressions  or  sinks  in  that 
region  averaging  about  600  feet  in  depth.     In  the  Libyan,  Sahara, 
and  Algerian  deserts  are  several  oases  of  less  depth.     The  Caspian 
Sea  is  85  feet  below  sea-level.    No  records  of  the  therapeutic  use  of 
any  of  these  places  are  obtainable.     On  the  North  American  conti- 
nent the  most  remarkable  and  important  depressed  climate  is  found 
in  southeastern  California,  in  the  Colorado  Desert.     It  is  located  in 
Riverside  County,  about  100  miles  from  Los  Angeles,  is  known  as 
the  Sink  of  San  Felipe  or  the  Conchilla  Valley,  and  is  crossed  by 
the  Southern  Pacific  Railroad.     It  is  about  130  miles  long  and  30 
miles  wide,  and  is  360  feet  below  sea-level  in  its  deepest   part. 
Numerous  palm-trees,  some  reaching  the  height  of  eighty  feet,  grow 
on  its  northern  margin,  close  under  the  mountains.     Dr.  Walter 
Lindley,  in  an  interesting  account  of  Indio, which  is  a  health-resort 
standing  some  50  feet  below  sea-level  on  the  northern  edge  of  this 
sink,  writes  as  follows.     He  begins  by  referring  to  Salton,  which 


PHTHISIS.  93 

is  at  the  southern  end  of  the  sink  on  the  line  of  the  Southern  Pacific 
Railroad,  and  about  270  feet  below  sea-level  : 

^^At  Salton,  on  the  Southern  Pacific  Railroad,  the  surface  of  the 
earth,  for  nearly  ten  miles  square,  is  covered  with  a  crust  of  salt 
from  four  inches  to  a  foot  thick.  I  stopped  there  in  midsummer 
and  went  out  on  this  great  white  field  about  noon.  The  mercury 
indicated  about  105°  F.  The  workmen  out  in  this  peculiar  har- 
vest-field were  as  cheerful  as  any  set  of  men  I  ever  saw,  and  there 
was  far  less  exhibition  of  suffering  from  heat  than  is  to  be  seen 
ordinarily  in  July  in  the  wheat-fields  of  the  Mississippi  Valley. 
The  low  relative  humidity  explains  the  total  absence  of  sunstroke 
here.  The  atmosphei'e  in  this  region,  adulterated  by  the  chlorine 
gas  emanating  from  the  salt-beds,  must  be  nearly  aseptic.  There 
are  extensive  mills  here  for  grinding  the  salt.  It  is  not  put  through 
any  system  of  purification,  but,  after  grinding,  proves  to  be  excel- 
lent for  table-use.  Several  hundred  tons  are  thus  prepared  every 
month  and  shipped  away. 

"A  few  miles  east  of  here  are  the  famous  mud-volcanoes,  which 
are  equal  in  wonder  to  the  geysers  of  this  State.  Owing  to  the 
treacherous  state  of  the  ground  around  them  they  have  never  been 
thoroughly  examined.  Professor  Hanks,  the  State  Mineralogist, 
undertook  it ;  but  breaking  through  the  crust  he  was  so  severely 
burned  that  he  was  compelled  to  abandon  his  investigations. 
Here  is  an  extensive,  almost  unexplored  field  for  some  adventurous 
scientist. 

"  In  this  valley  live  about  four  hundred  of  the  Cochuilla  Indians. 
This  is  an  interesting  tribe.  Dr.  Stephen  Bowers,  in  a  paper  read 
before  the  Ventura  County  Society  of  Natural  History,  March  5, 
1888,  said  that  he  believed  them  to  be  of  Aztec  origin.  They  are 
sun-  and  fire-worshippers,  and  believe  in  the  transmigration  of  souls, 
and  that  their  departed  friends  sometimes  enter  into  coyotes,  and 
thus  linger  about  their  former  habitation.  They  practise  cremation. 
The  ethnologist  can,  by  gaining  their  confidence,  get  much  inter- 
esting information  from  these  very  peaceable  Indians. 

"  I  found  at  Salton  and  Indio  asthmatics,  rheumatics,  and  con- 
sumptives, all  of  whom  report  wonderful  recoveries.  These  asth- 
matics and  consumptives  claim  that  the  further  they  get  below  sea- 
level  and  the  drier  the  atmosphere  the  easier  they  breathe.  The 
rheumatics  claim  that  the  heat  and  dryness  improve  the  circulation, 
and  thus  relieve  them. 


94  MEDICAL  CLIMATOLOGY. 

"  My  stay  was  not  long  enough  to  make  any  trustworthy  obser- 
vations, but  it  occurred  to  me  that,  aside  from  dryness — mean  annual 
relative  humidity  certainly  not  over  25  per  cent. — and  equability, 
there  was  considerable  atmospheric  pressure  at  a  point  three  hun- 
dred and  fifty  feet  below  sea-level,  and  that  we  had  here  moder- 
ately compressed  air  on  a  large  scale.  In  a  recent  paper  on  the 
use  of  the  pneumatic  cabinet  the  author  in  many  cases  in  practice 
shows  that  compressed  air  relieves  asthmatics  and  cases  of  phthisis. 
He  savs  that  compressed  air  will  gradually  force  its  way  into  every 
part  of  the  lung,  in  order  that  the  pressure  may  be  the  same  on  the 
inside  as  on  the  outside.  While  the  proportion  of  oxygen  is,  of 
course,  not  increased,  yet  there  is  an  increased  quantity  in  a  given 
space,  and  we  really  have  the  oxygen  treatment  here  on  an  exten- 
sive scale. 

''The  physician  may  say  that  at  from  two  hundred  to  three  hun- 
dred and  sixty  feet  below  sea-level  the  pressure  would  not  be  as  much 
as  in  the  cabinet.  That  is  true,  but  the  patient  goes  into  the  cabinet 
for,  say  half  an  hour,  three  or  four  times  a  week ;  while  if  he  is  at 
a  point  like  Salton,  he  is  breathing  this  moderately  compressed  air 
all  the  time,  day  and  night.  This  is  simply  on  the  principle  of  the 
pneumatic  chamber  of  Tabarie,  the  first  one  ever  employed.  This 
is  the  method  recommended  by  Dr.  A.  H.  Smith.  He  refers  to 
the  therapeutic  value  of  the  increased  amount  of  oxygen  inhaled. 
He  says  compressed  air  is  useful  in  catarrh  of  the  mucous  mem- 
brane, in  acute  and  subacute  inflammation  of  the  respiratory  mucous 
membrane,  in  restoring  the  permeability  of  air-tubes,  occluded  by 
exudation  or  otherwise,  in  asthma,  in  pulmonary  hemorrhage,  in 
pleuritic  effusion,  in  simple  ansemia,  in  inveterate  cases  of  psoriasis 
and  ichthyosis,  and  in  the  various  forms  and  stages  of  phthisis. 
He  does  not  recommend  it  in  pulmonary  emphysema.  Dr.  Smith 
says  compressed  air  should  he  used  promptly  and  perseveringly  on 
the  earliest  recognizable  signs  of  apical  catarrh  in  those  predisposed 
to  chest  disease.      He  also  especially  recommends  it  as  an  alterative. 

''  If  a  phthisical  or  asthmatic  patient  of  considerable  vigor  in- 
tends coming  to  Southern  California,  his  physician  might  be  justified 
in  suggesting  that,  except  during  the  summer  months,  he  stop  at 
Indio  and  from  there  test  the  climate  of  this  basin.  "^ 

During   the   summer   the  intense   heat    makes   residence   in   the 

1  Indio.    Walter  Lindley,  M.D.,  in  New  York  Medical  Record,  September  1, 1888. 


PHTHISIS.  95 

desert  impossible  for  the  delicate,  and  is  generally  a  drawback  to 
it  even  in  winter,  in  spite  of  the  very  low  humidity.  The  climate 
and  resources  of  Indio  are  mentioned  in  Section  III.  I  have  had 
some  slight  experience  with  patients  in  this  region,  and  believe  that 
it  has  a  place  in  climatic  therapeutics ;  but  I  am  not  yet  prepared  to 
regard  the  matter  as  anything  but  experimental.  The  observations 
of  physicians  who  have  used  compressed  air  give  some  indications 
for  the  theoretical  use  of  these  depressed  desert  climates ;  but  the 
moderate  increase  of  barometric  pressure  and  decided  increase  of 
dry  heat  qualify  considerably  any  deductions  that  may  be  drawn 
from  them.  While  the  accommodations  at  Indio  are  sufficiently 
comfortable,  luxury  and  variety  of  any  kind  are  absent,  and  while 
these  deficiencies  may  or  may  not  be  beneficial  to  the  patient,  it 
is  necessary  to  take  them  into  consideration  before  sending  him 
there. 

Compressed  Air.  Upon  the  therapeutic  uses  of  compressed  air 
Dr.  Andrew  H.  Smith  writes  as  follows  :  ''  Compressed  air  is  used 
remedially  in  two  ways:  the  first  is  by  placing  the  patient  in  a 
suitably  constructed  chamber  and  condensing  the  air  about  him  ; 
the  second  is  by  causing  the  patient  to  breathe  from  a  vessel  con- 
taining air  under  pressure. 

*'  By  the  first  of  these  methods,  to  which  alone  our  attention  will 
be  directed,  we  have  the  conditions  reproduced  which  we  have  already 
considered  in  connection  with  caisson- work,  except  that  the  pressure 
employed  is  very  much  less- — usually  not  more  than  ten  pounds  to 
the  square  inch.  The  physiological  results  are  such  as  we  have 
already  studied,  but  on  a  scale  reduced  in  proportion  to  the  lessened 
pressure. 

"  Pathological  results  ought  not  to  be  encountered  so  long  as 
proper  care  is  exercised  in  the  management  of  the  apparatus  and 
the  selection  of  cases. 

''  It  is  the  united  testimony  of  many  observers  that  the  therapeu- 
tical effects  are,  under  due  limitations,  of  the  greatest  practical  value. 

^'  The  treatment  by  compressed  air  in  this  form  is  applicable  to 
only  a  limited  circle  of  diseases.  It  is  in  place  only  when  equally 
good  results  cannot  be  obtained  by  more  convenient  and  more 
accessible  methods. 

''  The  general  indications  for  this  form  of  treatment  are  derived 
from  its  mode  of  action,  which  is  twofold  :  1.  As  simply  a  mechan- 
ical agent   by  virtue  of  the  pressure  upon  the  several  tissues  and 


96  MEDICAL  CLIMATOLOGY. 

organs.  2.  As  exciting  certain  chemico-physiological  processes  by 
greater  activity. 

"As  a  mechanical  agent  it  is  capable  of  lessening  hypersemia  in 
situations  accessible  to  direct  pressure. 

"As  a  consequence  of  this  it  lessens  hypersecretion,  and  is  useful 
in  catarrh  of  the  raucous  membranes.  It  also  promotes  the  reab- 
sorption  of  inflammatory  exudations. 

"  By  increasing  the  supply  of  blood  to  those  parts  less  accessible 
to  direct  pressure,  it  is  usefid  in  aniemia  of  the  brain  and  cord,  and 
can  be  employed  to  stimulate  the  functions  of  the  deep-seated  glan- 
dular organs,  as  the  liver  and  kidneys. 

"  It  tends  to  expand  the  pulmonary  air-vesicles,  increasing  the 
vital  capacity,  and  may  be  used  to  restore  the  permeability  of  air- 
tubes  occluded  by  exudation  or  otherwise. 

"  In  its  chemico-physiological  action  the  indications  for  the  use 
of  compressed  air  in  this  form  are  to  be  found  in  the  increase  which 
it  occasions  in  the  amount  of  oxygen  taken  up  in  the  lungs,  and  the 
improved  conditiou  of  the  blood  which  results.  This  is  shown  in 
the  more  rapid  oxidation  of  the  tissues,  in  the  greater  activity  of  the 
vital  processes,  and  in  increased  muscular  power. 

"This  use  of  compressed  air  is  contraiudicated  in  weakness  of 
the  heart  from  degeneration  of  the  muscular  fibre;  in  renal  disease 
accompanied  by  active  or  passive  congestion  ;  in  diseases  of  the 
spinal  cord  of  which  congestion  is  a  leading  feature;  in  hypertemia 
of  the  alimentary  canal,  of  the  ovaries,  and  of  the  uterus ;  and  in 
hyperpyrexia  especially  from  pulmonary  disease  (Oertel)."^ 

Dr.  Smith  goes  on  to  state,  mostly  on  the  authority  of  Oertel  and 
Simonhof,  giving  apparently  no  clinical  experiences  of  his  own,  his 
belief  in  the  beneficjal  influence  of  compressed  air  in  such  conditions 
as  acute  and  subacute  inflammation  of  the  respiratory  mucous  mem- 
brane and  the  upper  air-passages,  provided  the  inflammation  is  not  of 
long  standing.  He  also  recommends  it  in  pulmonary  emphysema, 
bronchial  asthma,  and  certain  forms  of  phthisis,  particularly  because 
of  the  improvement  that  it  causes  in  the  general  nutrition.  He  writes 
that  in  chronic  phthisical  parenchymatous  inflammation  of  the  lungs 
"  the  results  are  far  less  favorable,  and  only  palliation  can  be  usually 
looked  for,  fever  being  an  unfavorable  indication,  while  hiemoptysis 
is  not  necessarily  so  ;  but  it  is  contraindicated  when  large  cavities 

1  The  Physiological,  Pathological,  and  Therapeutic  EfiFects  of  Compressed  Air.     Andrew  H. 
Smith,  M.D. 


PHTHISIS.  97 

are  present.  Pleuritic  effusions  are  usually  much  benefited  and 
sometimes  empyemas."  In  organic  cardiac  disease  opinions  differ, 
Pravaz  and  Devay  being  opposed  to  its  use,  while  most  other  writers 
commend  it. 

For  obesity,  anpemia  and  chlorosis,  litha?mia,  and  in  certain  hyjicr- 
semic  conditions  it  is  stated  to  be  useful.  Smith  concludes  with  these 
words  :  "•  Finally,  as  a  general  alterative  this  method,  combining  as 
it  does  a  vital  effect  upon  the  constitution  of  the  blood  and  a  mechan- 
ical effect  upon  its  distribution,  offers  promise  of  benefit  in  cases  not 
amenable  to  ordinary  measures." 

Dr.  Theodore  Williams  discussed  the  treatment  at  some  length  in 
his  lectures  on  the  compressed  air-bath  and  its  uses  in  the  treatment 
of  disease.^  In  his  recent  work  on  Aerotherapeutics  he  gives  the 
following  condensed  statements  of  the  effects  of  compressed  air  in 
lung-diseases  :  "  We  will  now  consider  the  effects  of  compressed  air 
on  various  lung-diseases,  and  I  may  state  that  my  conclusions  in 
the  present  instance  are  based  on  cases  from  my  private  note-books 
and  on  sixty-six  patients  suffering  from  various  forms  of  lung- 
disease  under  my  care  at  the  Brompton  Hospital  treated  in  these 
baths,  most  carefully  tabulated  by  my  late  house-physician.  Dr. 
Horrocks. 

"  Asthma.  Of  bronchial  asthma  there  were  15  cases — 10  males 
and  5  females.  In  7  asthma  was  largely  complicated  with  em- 
physema. The  average  number  of  baths  taken  was  from  12  to  15. 
Of  these  patients  12  improved  and  3  did  not  improve.  Out  of 
11  whose  weights  were  taken  9  gained  weight — on  an  average  4f 
pounds — and  2  lost.  The  measurement  of  the  circumference  of  the 
thorax  at  various  levels  was  made  in  7  patients  before  and  after  the 
baths,  and  the  circumference  increased  in  4  and  diminished  in  3. 
The  spirometer  showed  an  increase  of  25  to  33  per  cent,  in  the  3 
cases  in  which  this  test  was  applied.  The  principal  effect  of  the 
baths  on  asthma  appears  to  be  sedative  to  the  pulmonary  plexuses 
of  nerves  and  to  the  pneumogastric.  The  attacks  are  rendered  less 
severe,  and  after  a  course  of  twenty  or  thirty  baths  the  intervals 
between  the  attacks  become  much  longer.  I  do  not  remember  one 
case  where  a  complete  cure  was  effected,  but  I  recollect  several 
where  the  patient  remained  free  for  months,  and,  in  one  instance, 
for  years  from  asthma.      The  effect  on  the  paroxysm  is  immediate 

1  Smith,  Elder  &  Co.,  London. 


98  MEDICAL  CLIMATOLOGY. 

and  wonderfully  efficacious — in  fact,  more  so  than  any  medicines, 
and  many  asthmatics  have  expressed  to  me  the  wish  that  they  could 
live  in  the  bath  and  thus  be  freed  from  their  sufferings.  The  effect 
on  the  emphysema  accompanying  it  is  to  reduce  it,  as  percussion 
and  auscultation  siiow. 

"  Chronic  Bronchitis  and  Emphysema.  In  chronic  bronchitis 
and  emphysema  the  effect  is  satisfactory;  the  cough  diminishes  and 
the  expectoration  is  lessened  ;  weight  is  gained  ;  breathing  is  easier; 
but  the  great  feature  is  the  reduction  of  the  emphysema.  Examina- 
tion of  the  chest  shows  diminution  of  the  hyper-resonance  and  a 
return  of  the  various  displaced  organs  to  their  normal  positions,  and 
cyrtometric  measurements  give  a  reduction  of  the  chest-circumference 
at  different  levels,  a  reduction  varying  from  J  to  1|  inches.  This 
indicates  that  a  great  deal  of  emphysema  even  in  adults  is  of  a  tem- 
porary nature,  produced  often  by  severe  paroxysms  of  coughing  or 
dyspnoea,  and  capable  of  reduction  if  respiration  be  rendered  more 
easy,  as  in  a  compressed-air  atmosphere.  In  my  33  cases  of  chronic 
bronchitis  and  emphysema,  who  had  on  an  average  eighteen  baths, 
15  were  measured  cyrtometrically,  and  of  these,  11  were  found  to 
have  decreased  in  circumference  and  4  to  have  increased;  26  of  the 
patients  improv^ed  geuerally,  5  did  not  improve,  and  2  died,  1  of 
heart-failure  from  cardiac  dilatation  after  five  baths,  and  the  other 
from  an  attack  of  capillary  bronchitis  after  having  greatly  improved 
from  nine  baths,  when  he  contracted  fresh  bronchitis  and  died  later. 

"Phthisis.  My  experience  cf  compressed  air  in  phthisis  is  not 
altogether  favorable.  In  9  of  these  cases  I  submitted  to  the  bath 
there  were  gain  of  weight  and  some  diminution  of  cough  and  expec- 
toration, and  apparently  the  respiration  became  freer  in  the  unaf- 
fected portions  of  the  lungs ;  but  in  2  cases  the  bath  appeared  to 
bring  on  hteraoptysis,  and  in  4  patients  haemoptysis  came  on  during 
the  treatment,  though  it  could  not  be  distinctly  connected  with  it. 
Beyond  the  opening  up  or  aeration  of  portions  of  the  lung  which 
had  not  been  brought  into  play  for  some  time,  I  could  see  none  of 
the  improvement  resulting  from  compressed  air  which  is  so  loudly 
proclaimed  by  Oertel  and  Simonhoff,  nor  could  I  discover  that  it 
facilitated  the  absorption  of  lung-consolidations  or  infiltration,  though 
cases  of  this  class  were  submitted  to  the  bath;  or,  lastly,  that  it  pro- 
moted, as  Oertel  states,  the  absorption  of  serous  exudation  in  acute 
pleurisy  and  tended  to  expand  the  compressed  lung.  INIy  experience 
is  that  it  exercises  no  effect  in  expanding  a  lung  which  has  been 


PHTHISIS.  99 

compressed  with  fluid  when  the  fluid  has  been  removed,  and,  even 
after  a  course  of  air-baths  steadily  persevered  in,  the  fluid  will  reac- 
cumulate  and  will  make  itself  known  by  indubitable  physical  signs 
and  by  the  diminishing  amount  of  expiratory  power,  as  evidenced 
by  the  spirometer.'" 

Caisson-disease.  As  explaining  most  satisfactorily  the  pathology 
of  the  caisson-disease,  the  article  by  Dr.  Howard  Van  Reussalaer^ 
should  be  consulted. 

In  France  experimental  investigation  has  for  some  time  been 
directed  to  the  discovery  of  the  cause  of  the  symptoms  character- 
izing this  afiection.  The  experiments  of  M.  Hersent,  a  French 
engineer,  are  particularly  interesting,  and  through  them  he  has 
arrived  at  the  opinion  that  the  loss  of  life  among  workmen  engaged 
in  the  construction  of  submarine  masonry,  etc.,  is  due  to  quick 
changes  in  the  degree  of  compression.  In  his  experiments  dogs 
were,  with  safety,  exposed  to  a  pressure  of  from  seventy- five  to  eighty 
pounds  to  the  square  inch  for  five  hours;  but  it  was  uecessary  that 
the  increase  of  pressure  should  be  gradual,  occupying  at  least  twenty- 
five  minutes,  and  its  decrease  was  a  much  slower  process,  lasting  for 
ninety  minutes.  A  uniform  temperature  was  maintained  through- 
out. These  tests  were  afterward  applied  with  still  greater  caution 
to  workmen,  and  produced  merely  a  degree  of  languor,  a  tingling  of 
the  surface  of  the  skin,  and  lumbago.  M.  Hersent  thus  established 
the  fact  that  workmen  can  successfully  pursue  their  avocations  for 
four  consecutive  hours,  or  even  longer,  exposed  to  a  compression  of 
over  seventy-five  pouuds,  provided  that  the  temperature  be  uniform 
and  that  the  change  in  pressure  be  gradual.  This  amount  of  com- 
pression is  the  same  as  that  felt  at  a  depth  of  150  to  175  feet  below 
sea -level. 

Elevated  Climates.  The  physical  and  physiological  effects  of 
diminished  barometric  pressure  have  been  discussed  in  preceding 
chapters,  and  we  will  now  further  consider  it  only  in  connection 
with  elevated  climates,  as  its  effects  are  so  intimately  associated 
with  the  other  elements  of  high  altitude.  It  was  stated  previously 
that  experiments  have  proved  that  the  most  important  effect  of 
diminished  barometric  pressure  was  to  increase  the  amount  of  haemo- 
globin and  red  corpuscles  in  the  blood.  Regnard  established  this 
truth,  as  will  be  detailed  later.      This  hsematogenic  effect  undoubt- 

1  Aerotberapeutics.    C.  T.  Williams,  M.D.  -  Medical  Record,  August  8, 1896. 


100  MEDICAL  CLIMATOLOGY. 

edly  explains  two  facts — first,  that  phthisis  is  rarer  in  elevated 
climates  than  in  others  even  when  due  allowance  is  made  for 
sparsity  of  population,  variety  of  occupation,  and  for  the  qualities 
ascribable  to  altitude ;  secondly,  that  consumptives,  as  a  class,  are 
more  benefited  by  high  altitudes  than  any  others,  as  proved  by 
statistics.  Combining  these  two  facts  in  relation  to  the  blood- 
changes  referred  to,  we  are,  I  believe,  justified  in  stating  that  dimin- 
ished barometric  pressure  is  the  chief  cause  both  of  the  rarity  of 
phthisis  and  of  the  exceptionally  high  average  of  improvement  in 
high  altitudes.  The  special  reason  for  the  infrequency  of  phthisis 
probably  is  that  the  increased  germicidal  power  of  the  blood  makes 
it  more  difficult  for  the  bacilli  to  effect  a  lodgement  in  the  tissues 
of  the  iohabitants  of  elevated  regions.  In  suitable  cases  of  con- 
sumption (and  by  suitable  cases  I  mean  chiefly  those  tending  to 
the  pure  tuberculous  type)  the  improvement  is  apparently  due, 
primarily,  to  the  checking  of  the  further  growth  of  the  bacilli  by 
the  germicidal  quality  of  the  blood  j  secondarily,  to  the  counter- 
acting by  the  same  quality  of  the  effect  of  the  septic  conditions 
which  usually  ensue;  and,  thirdly,  to  the  correction,  through  the 
improved  characteristics  of  the  blood,  of  the  anaemia  and  cardiac 
weakness  which  almost  invariably  exist  in  tuberculous  cases  as  ^vell 
as  in  all  forms  of  phthisis.  Thus  the  tuberculosis  which  cannot  be 
eliminated  is  li.mited,  and  the  general  powers  of  resistance  of  the 
patient  are  increased. 

Before  proceeding  to  give  at  greater  length  the  evidence  as  to  the 
blood-changes  produced  by  altitude,  it  will  be  well  to  quote  at  length 
the  opinions  of  Hirsch  and  other  authorities  upon  the  comparative 
immunity  from  phthisis  to  be  found  in  elevated  regions,  aud  its 
apparent  causes. 

"The  observations  published  by  Archibald  Smith  and  Tschudi 
as  to  the  extreme  rarity  of  phthisis  on  the  high  plateaus  of  the 
Andes  in  Peru,  aud  as  to  the  good  effects  upon  the  phthisical  of  a 
residence  thereon,  were  the  first  statements  to  direct  general  atten- 
tion to  the  comparative  immunity  from  consumption  of  regions  at  a 
great  elevation.  Further  inquiries  in  the  same  direction  have  con- 
firmed the  general  fact,  but  they  have  in  part  also  given  color  to 
an  opposite  conclusion,  so  that  the  question  may  be  said  to  be  still 
suh  judice  for  those  who  would  decide  it  absolutely  and  without 
regard  to  accessory  circumstances. 

''It  is  not  to  be  denied  that  phthisis  does  occur  at  the  highest 


PHTHISIS.  101 

inhabited  spots  on  the  globe,  and  that  it  is  rare  in  many  places  situ- 
ated on  low  plains  ;  none  the  less  it  is  an  incontestable  fact  that  con- 
sumption is,  cceteris  paribus,  much  less  frequently  met  with  at  high- 
lying  places  than  in  those  at  a  lower  elevation  or  on  tiie  sea-level. 
Not  only  so,  but  the  number  of  cases  stands  in  some  kind  of  definite 
proportion  to  the  degree  of  elevation,  while  the  exceptions  to  the 
general  rule  find  satisfactory  explanation  in  other  etiological  factors 
coming  into  play  at  the  same  time. 

''The  rarity  of  phthisis  at  high  elevations  is  well  shown  in  the 
returns  of  sickness  from  that  most  extensive  of  the  earth's  mountain- 
chains  which  runs  along  the  whole  Pacific  coast  of  the  Western 
Hemisphere.  For  the  Rocky  Mountains  of  North  America  we  have 
evidence  of  the  fact  from  a  number  of  places  in  the  territories  situ- 
ated toward  the  southern  end  of  the  range,  such  as  New  Mexico, 
Arizona,  Colorado,  and  also  Utah.  In  like  manner  all  the  authori- 
ties speak  of  the  rarity  of  the  disease  on  the  plateaus  and  mountain- 
slopes  of  Mexico,  Guatemala,  Salvador,  Costa  Rica,  and  Panama 
(for  example,  on  the  Cordilleras  of  Veragua  and  Chirigui).  From 
Bogota,  in  New  Granada,  Holden  writes  that  he  did  not  see  one 
consumptive  person  in  the  hospitals  of  the  town  during  a  prolonged 
residence  there.  Referring  to  Quito,  Ecuador,  Gayraud  and  Domec 
say  :  '  Notre  experience  personelle  nous  permet  d'affirmer,  que  la 
phthisic  y  est  tellement  rare  qu'elle  u'y  existe  pas,  au  moins  comme 
maladie  prenant  naissance  dans  le  pays  lui-merae.  .  .  .  Le  fait 
est  done  pour  nous  indubitable,  on  ne  devieut  pas  phthisique  a 
Quito.'  " 

For  the  Peruvian  Andes  we  have  the  statements  of  Smith  and 
Tschudi,  already  mentioned.  During  a  year's  stay  on  the  Cerre 
Pasco  the  former  saw  only  one  case  of  consumption,  and  that  was 
in  a  woman  who  had  come  from  Europe.  ''There  is  no  doubt," 
says  Andrew,  "  that  as  regards  altitude  the  prevalence  of  phthisis  at 
considerable  heights,  although  instances  of  it  do  exist,  is  exceptional ; 
and  Burkhart  mentions  that  he  had  not  seen  a  single  case  of  phthisis 
during  a  period  of  three  mouths  among  the  Europeans  occupied  at 
the  mines  in  Mexico. 

"  In  those  parts  of  the  Argentine  Republic  that  are  within  the 
limits  of  the  Andes  the  influence  of  high  elevations  upon  the  rarity 
of  phthisis  is  observable  as  far  down  as  Salta  ;  it  is  still  more 
obvious  in  the  elevated  valleys  on  the  western  side  as  well  as  on 
the  Bolivia  plateau  at  Chuquisaca,  Cochabamba,  Potosi,  and  other 


102  MEDICAL  CLIMATOLOGY. 

places.  In  the  mountainous  parts  of  Guiana  also  consunaptiou  is 
almost  unknown, 

"  In  the  Eastern  Hemisphere  this  immunity  from  phthisis  is  shown 
most  decidedly  on  the  plateau  of  Armenia,  where  the  disease  is  found 
almost  solely  among  those  who  have  come  from  less  elevated  places ; 
also  on  the  tableland  of  Persia,  where  it  is  extremely  rare,  and  among 
the  natives  of  the  country  almost  unknown  ;  on  the  northern  and 
southern  slopes  of  the  Himalayas,  at  the  elevated  points  of  the 
Western  Ghats,  on  the  Nilghiri  Hills,  on  ^Slouut  Abu  (4000  feet) 
in  the  Aravalli  range,  and  in  Nearer  India ;  on  the  plateau  of 
Abyssinia  and  on  those  of  southern  Africa. 

"  In  Europe  a  certain  rarity  of  phthisis  begins  to  be  noticeable  even 
at  comparatively  small  elevations,  as  in  the  Iser  range,  on  the 
northern  spurs  of  the  Carpathians,  in  Upper  Silesia,  on  the  elevated 
plain  of  Thuringia,  in  the  ITpper  Hartz,  and  in  the  Spessart. " 

Writing  of  Upper  Silesia,  Virchow  says  :  ' 'Although  I  have  seen 
an  exceptionally  large  number  of  sick  persons  of  the  poorer  class 
both  in  town  and  country  at  their  homes  aud  in  hospitals,  yet  there 
has  not  come  under  my  notice  a  single  case  of  phthisis  ;  and  the 
statements  of  the  medical  men  bear  out  the  notion  that  the  disease 
is  rare.  In  the  Upper  Hartz  consumption  is  so  unusual  that  Brock- 
mann,  during  a  practice  of  many  years  and  extending  to  eighty  thou- 
sand sick  persons,  found  only  twenty-three  phthisical  patients,  of 
whom  only  fourteen  had  been  born  in  the  Upper  Hartz  ;  in  the 
lower  valleys  the  malady  is  more  common,  but  the  high  plateau  is 
almost  exempt."  In  the  Spessart,  according  to  Virchow,  phthisis  is 
not  so  rare,  although  in  the  lower  villages  he  met  with  only  an 
occasional  case,  and  the  registers  of  deaths  rarely  contained  the  entry 
of  consumption  or  decline.  I  shall  add  here  the  interesting  note  by 
Gross  that  consumption  is  almost  unknown  in  Brian^on  (Hautes- 
Alpes),  the  most  elevated  town  in  Europe  (1306  metres,  or  4285 
feet),  although  the  place  is  a  small  fortress  with  a  number  of  indus- 
tries and  a  good  deal  of  filth. 

Statistical  inquiries,  such  as  have  been  made  in  Saxony,  Baden, 
and  Switzerland,  in  regard  to  the  prevalence  of  phthisis  in  the  elevated 
regions  as  compared  with  low-lying  districts  close  at  hand  (due  allow- 
ance being  made  for  any  diiferences  in  the  mode  of  life),  have  con- 
firmed the  law  of  immunity  of  the  more  elevated  places  from  phthisis 
which  had  been  deduced  from  the  study  of  the  higher  elevations  by 
themselves.     The  following  is  Merbach's  table  for  Saxony,  based  on 


PHTHISIS.  103 

a  period  of  three  years,  from  1873  to  1875,  and  inciuding  only 
those  towns  which  have  more  than  five  thousand  inhabitants,  and 
only  patients  whose  ages  range  from  fourteen  to  sixty  years : 

Altitude  in  metres  Deaths  from  phthisis  within 

{2,}i  feet).  the  limit  of  age. 

100    to    200 4.9    in    1000 

200     "300 3.3     "     1000 

300     "400 3.2     "     1000 

400     "500 3.5     "     1000 

550     "650 3.3     "     1000 

Merbach  concludes  as  follows  :  ' '  There  is  certainly  nothing  shown 
here  of  any  marked  influence  due  to  the  elevation  of  the  various 
localities,  or  of  such  an  influence  as  would  cause  the  number  of 
deaths  from  phthisis  to  decrease  pari  passu  with  the  increase  in 
elevation.  A  result  of  that  sort  was  indeed  not  to  be  looked  for, 
inasmuch  as  the  several  towns  are  subject  to  other  influences — and 
some  of  them  noxious  ones,  such  as  the  occupation  of  the  inhabi- 
tants, the  density  of  the  population,  etc. — which  are  capable  of  neu- 
tralizing the  effect  of  an  elevated  location.  At  the  same  time,  even 
in  instances  before  us,  the  good  effects  (otherwise  sufiiciently  proved) 
of  a  high  situation  upon  the  prevalence  of  consumption  can  hardly 
be  overlooked  whenever  we  begin  to  compare  the  villages  in  lowest 
situation  with  those  in  the  highest.  .  .  .  The  contrast  comes 
out  with  special  clearness  when  the  averages  calculated  for  towns 
situated  at  one  and  the  same  level  are  compared  together." 

Corval  has  worked  out  this  relationship  from  the  Baden  bills  of 
mortality  over  a  period  of  four  years  (1869-'72),  including  in  his 
total  all  those  cases  in  which  the  cause  of  death  was  given  as  tuber- 
culosis, ''  chronic  pneumonia,"  or  ^'phthisis."  He  distinguishes  six 
groups  of  localities  according  to  elevation  : 

Table  of  Mortality  from  Phthisis  in  Baden,  according  to 

Elevation. 

Elevation  No.  of  towns  Population,  Deaths  from 

in  feet.  or  villages.  aver,  of  4  yrs.  phthisis  per  1000. 

I.        300-1000  750  933,773  3.36 

II.      1000-1500  337  224,210  2.75 

III.  1500-2000  160                  81.066  2.60 

IV.  2000-3000  190  104,289  2.75 
V.      2500-3000  97                  59,155  2.33 

VI.  Above  3000  47  20,367  2.17 

In  order  to  ascertain  what  effect  is  produced  upon  the  death-rate 
from  phthisis  by  density  of  population,  industrial  pursuit.s,  and  other 


104  MEDICAL  CLIMATOLOGY. 

conditions  peculiar  to  towns,  we  may  make  a  calculation  of  the  mor- 
tality according  to  the  size  of  every  town  or  village  in  Baden,  using 
Corval's  figures.  We  shall  find  that  it  is  3.12  per  1000  inhabi- 
tants for  the  whole  of  Baden,  3.00  for  villages  of  3000  and  under, 
3.49  for  towns  from  3000  to  10,000,  and  4.56  for  towns  with  more 
than  10,000  inhabitants.  If,  now,  we  arrange  the  places  that  are 
respectively  over  and  under  3000  population  in  two  columns,  classi- 
fying them  in  six  groups  according  to  elevation,  we  shall  get  the  fol- 
lowing table  of  the  death-rate  from  .phthisis: 

Altitude-groups.  Under  3000  population.      Over  3000  population. 

1 3.11  4.05 

II 2.73  3.08 

III 2.49  4.99 

IV.       .        .         .         .         .         .  2.71  4.72 

V 2.29  3.06 

VI 2.17 

In  the  series  with  less  than  3000  inhabitants  the  favorable  influ- 
ence of  increasing  elevation  is  quite  obvious;  but  in  the  second 
column  of  death-rates  it  will  be  seen  that  the  benefit  is,  in  some 
instances,  neutralized  by  detrimental  factors  belonging  to  the  social 
and  industrial  life  of  the  larger  centres  or  the  towns.  Still  from 
the  facts,  such  as  they  are,  we  have  adopted  Corval's  conclusions, 
''that  cases  of  phthisis  decrease  with  increasing  elevation;  or,  in 
other  words,  in  mere  increase  of  altitude  we  may  discover  one  of 
the  most  important  factors  in  checking  the  development  of  consump- 
tion." 

Muller's  inquiries  into  the  effect  of  elevation  upon  the  prevalence 
of  phthisis  in  Switzerland  have  led  him  to  the  same  conclusion, 
although  the  results,  as  he  is  careful  to  explain,  can  only  be  said  to 
be  approximately  correct,  for  the  reason  that  the  data  at  his  service 
were  not  free  from  a  good  many  omissions  and  errors.  He  distin- 
guished three  groups  of  places:  1.  Those  in  which  from  43  to  63 
per  cent,  of  the  inhabitants  follow  some  industrial  occupation  (can- 
tons o.f  Outer  Appenzell,  Glarus,  Neufchatel,  town  and  country  divi- 
sions of  Basle,  and  Geneva).  2.  Where  the  industrial  part  of  the 
population  reaches  from  31  to  43  per  cent,  (cantons  of  Zurich,  St. 
Gall,  Thurgau,  Zug,  Inner  Appenzell,  Aargau,  Schaffhausen,  Solo- 
thurn,  Bern,  Ticino).  3.  The  agricultural  cantons,  where  the  in- 
dustrial population  is  only  from  13  to  26  per  cent,  of  the  whole 
(Lucerne,  Schwyz,   Unterwalden,  Vaud,   Freiburg,   Grisons,  Uri, 


PHTHISIS.  105 

Vallais).  Grouping  the  places  in  each  of  these  divisions  according 
to  their  elevation  within  a  limit  of  200  to  1 800  metres  (650  to  6000 
feet),  we  get  the  following  table  of  death-rates  : 

Table  of  Death-rates  from  Phthisis  in  Saviss  Towns  and 
Villages. 


Elevation 
(in  metres). 

Industrial 
Cantons. 

Mixed 
Cantons. 

Agricultural 
Cantons. 

Average. 

200-  500 

2.7 

1.85 

1.4 

2.15 

500-  700 

3.0 

.     4.55 

1.2 

1.9 

700-  900 

1.35 

1.7 

0.7 

1.0 

900-1100 

1.5 

1.9 

1.9 

1.2 

1100-1300 

2.3 

2.3 

0.7 

1.9 

1300-1500 

. . . 

1.4 

0.6 

0.8 

1500-1800 

... 

1.3 

0.7 

1.0 

Average,  2.55  1.7  1.1  1.86 

Miiller  concludes  from  these  facts  "  that  in  Switzerland  consump- 
tion can  be  shown  to  decrease  as  we  ascend;  that  the  malady  does 
occur,  although  rarely,  at  the  highest  inhabited  spots;  that  the 
lowest  localities  have  on  the  average  about  twice  as  many  consump- 
tives as  the  highest,  and  very  much  more  than  that  if  the  cases 
where  the  phthisis  had  been  acquired  elsewhere  be  subtracted;  and 
that  the  decrease  of  phthisis  with  ascending  elevation  is,  however, 
neither  constant  nor  proportional;  and  that  the  irregularities  and 
fluctuations  which  are  noticeable  are  owing  mostly  to  the  position 
in  the  social  scale,  inasmuch  as  the  industrial  group  of  places  shows 
the  irregularities  most,  and  the  mixed  groups,  on  the  whole,  a  regu- 
lar decrease  with  height;  while  the  agricultural  groups  touch  their 
lowest  death-rates  at  a  comparatively  small  elevation. 

''  What  the  minimum  of  elevation  is  that  a  locality  must  have 
before  it  feels  the  good  effects  of  altitude  on  the  prevalence  of  con- 
sumption is  a  question  that  cannot  be  answered  with  certainty  from 
the  facts  before  us.  Gastoldi  puts  it  at  600  to  1000  metres  (2000  to 
3300  feet).  It  seems  to  me,  however,  that  a  notable  decrease  in  the 
disease  can  be  shown  to  occur  at  as  small  an  elevation  as  400  or  500 
metres  (1500  feet),  provided  other  circumstances  are  favorable. 
But  any  immunity  from  phthisis  due  to  the  height  of  the  place 
does  not  come  out  decidedly  until  we  go  to  elevations  so  great  as  to 
be  uninhabitable  in  temperate  climates  like  that  of  Europe.  We 
must  go  to  the  equatorial  parts  of  the  world  to  study  the  .sanitary 
effects  of  altitude  ranging  from  2000  to  3000  metres  (6000  to  10,000 


106  MEDICAL  CLIMATOLOGY. 

feet);  and,  inasmuch  as  the  question  is  one  of  populous  places  and 
the  seats  of  industry,  we  must  take  the  large  towns  on  the  plateaus 
of  the  Andes  in  Central  and  South  America,  such  as  Puebla,  wdth 
80,000  inhabitants,  and  at  an  elevation  of  2300  metres,  or  7500  feet; 
Mexico  (320,000  inhabitants,  7500  feet);  Quito  (60,000  inhabit- 
ants, 9300  feet);  Bogota  (40,000  inhabitants,  8500  feet);  Chu- 
quisaca  (25,000  inhabitants,  9800  feet);  Cochabamba  (40,000 
inhabitants,  11,000  feet);  and  Potosi  (20,000  inhabitants,  13,000 
feet). 

"  Causes  of  Rarity.  In  all  of  these,  which  are  to  some  extent 
industrial  towns,  or  at  any  rate  much  occupied  with  trade  and  com- 
merce, and  by  no  means  models  of  good  sanitation,  consumption, 
according  to  the  unanimous  testimony,  is  either  rare  or  among  the 
natives  it  does  not  occur  at  all.  And  that  is  a  proof  that  the  influ- 
ences which  go  with  a  very  considerable  altitude  have  the  power 
to  overcome  those  detrimental  things  which  arise  from  a  bad  kind 
of  hygiene  and  social  life,  in  so  far  as  these  tend  to  produce  con- 
sumption. 

"Opinions  differ  as  to  the  nature  of  the  influence  of  altitude. 
Some  trace  the  beneficial  effects  to  the  freedom  of  the  air  from 
decomposition-products — dust  and  the  like;  others  to  the  dryness 
of  the  air  and  soil;  but  both  of  these  opinions  seem  to  me  to  be 
overthrown  by  the  details  given  above,  as  well  as  by  the  fact  that 
immunity  from  consumption  is  found  equally  on  dry  and  on  damp 
plains,  or  in  mountain-valleys  abounding  in  lakes  and  pools,  pro- 
vided only  that  they  possess  a  considerable  elevation.  The  only 
explanation  that  I  can  offer,  and  one  to  which  I  shall  hold  until 
something  more  satisfactory  presents  itself,  is  that  people  who  have 
been  brought  up  at  great  elevations  have  been  always  under  the 
necessity  of  taking  frequent  (or  perhaps  deep)  inspirations  as  a  con- 
sequence of  breathing  rarefied  atmosphere — that  they  are  continu- 
ally practising  a  kind  of  pulmonary  gymnastics,  from  which  there 
proceed  a  vigorous  development  of  the  breathing-organs  and  a 
greater  power  of  resistance  on  their  part  to  noxious  influence  from 
without.'' 

"After  looking  at  the  bustle  of  traffic  in  towns  like  Bogota, 
Micuipampa,  Potosi,  at  elevations  of  8000  to  12,000  feet,"  says 
Boussaingault;  "  after  witnessing  the  strength  and  marvellous  skill 
of  the  toreadors  in  the  bull-fights  at  Quito,  9000  feet  above  the 
sea-level;   after  seeing  young  and  delicate  girls  dancing  a  whole 


PHTHISIS.  107 

night  at  places  almost  as  high  as  Mont  Blanc,  on  which  the  cele- 
brated Saiissure  had  hardly  strength  enough  to  use  his  instruments 
of  observation,  and  his  hardy  guides  fell  down  in  a  swoon  as  they 
proceeded  to  dig  a  hole  in  the  snow;  when  we  remember,  finally, 
that  the  famous  battle  of  Pichincha  was  won  almost  in  the  altitude 
of  Monte  Rosa — 1  think  that  you  will  agree  with  me  that  man  can 
become  adapted  to  breathing  the  rarefied  air  of  the  very  highest 
mountains.  I  will  readily  grant  that  many  of  the  accounts  of 
embarrassed  breathing  experienced  by  the  natives  of  the  plains  on 
ascending  very  high  mountains  are  exaggerated  ;  and  f  must  con- 
fess that  in  my  own  case,  after  resting  a  short  time  at  elevations  of 
ten  thousand  feet  and  upward,  I  was  conscious  of  no  considerable 
want  of  breath,  or  did  not  become  aware,  at  least,  of  any  need  for 
quicker  and  deeper  inspirations.  At  the  same  time  it  is  not  to  be 
denied  that  the  atmosphere  at  elevations  of  ten  thousand  feet,  espe- 
cially in  a  warm  climate,  is  rarefied  to  the  extent  of  more  than  one- 
third  of  its  volume  at  the  sea-level.  The  quantity  of  oxygen  con- 
tained in  it  is  therefore  considerably  diminished,  and  a  man  must 
take  in  a  larger  quantity  of  air  in  a  given  time  or  must  inspire 
oftener  than  on  the  plains  so  as  to  cover  his  requirements  for  oxy- 
gen. To  that  assumption  no  well-grounded  objection  can  be  raised, 
whether  from  the  side  of  physics  or  of  physiology;  and  there  is 
equally  little  reason  why  we  should  not  assume  that  those  who  have 
been  born  and  have  lived  all  their  lives  under  such  circumstances 
will  have  had  their  breathing-organs  powerfully  developed.  I  do 
not  hesitate,  therefore,  to  believe  that  the  reason  of  the  immunity 
from  phthisis  enjoyed  by  the  residents  of  elevated  places  is  the  in- 
fluence which  a  continuous  residence  in  a  rarefied  atmosphere  exer- 
cises over  them. 

''On  the  other  side,  we  may  thus  further  explain  the  exemption 
from  phthisis  of  many  parts  of  the  world  by  reason  of  their  favor- 
able weather-conditions  and  the  consequent  rarity  of  all  pulmonary 
affections  therein.  The  immunity  from  consumption  enjoyed  by 
natives  of  elevated  regions  seems  to  me  to  be  referable  to  a  pecu- 
liarly strong  development  of  their  breathing-organs  and  a  corre- 
sponding power  of  resistance  iu  them  to  noxious  influences  from 
without.  It  is  proved  that  this  is  now  not  all  an  afl^air  of  '  purity 
of  the  atmosphere,'  and  as  some  have  supposed  by  the  fact  that 
the  state  of  hygiene  in  the  towns  of  Ecuador,  Bolivia,  and  Peru, 
situated  at  a  great  elevation,  is  by  no  means  distinguished  for  its 


108  MEDICAL  CLIMATOLOGY. 

excellence,  for  cleanliness  in  the  houses  or  streets,  adequate  ventila- 
tion of  the  rooms,  and  the  like." 

The  Physiological  Effects  of  Altitude  upon  Phthisis.  It  will 
be  noted  that,  at  the  time  Hirsch  wrote,  the  effect  of  diminished 
barometric  pressure  upon  the  blood  was  unknown,  and  he  ascribes 
freedom  from  phthisis  in  high  altitudes  to  the  powerful  development 
of  the  lungs  caused  by  breathing  the  rarefied  air  and  their  consequent 
heightened  power  of  resistance  to  noxious  influences  from  without, 
and  he  says  that  the  purity  of  the  atmosphere  is  not  the  only  cause. 

In  regard  to  the  differences  between  high  and  low  climates  and 
the  causes  and  results  of  such  differences,  perhaps  a  general,  short 
view  of  the  whole  matter  is  best  given  in  the  words  used  by  the 
author  in  addressing  the  American  Public  Health  Association,  in 
October,  1895: 

Looking,  first,  at  the  physical  facts,  we  find  there  is  one  element 
only,  but  a  most  important  one,  which  a  high  climate  possesses  and 
a  low  one  does  not,  viz.,  diminished  barometric  pressure.  While 
possessing  also  in  an  unusual  degree  and  combination  abundance  of 
sunshine  and  pure,  cool,  dry  air,  it  shares  these  more  or  less  with 
other  climates.  Much  speculation  and  various  theories  have  been 
indulged  in  to  explain  the  effects  of  reduced  barometric  pressure. 
When  I  first  came  to  live  in  Colorado  Springs,  now  some  twenty- 
one  years  since,  the  solution  to  the  problem  was  hindered  by  wrong 
conclusions  drawn  by  the  great  traveller  and  scientist.  Von  Hum- 
boldt. Since  then  physiologists  have  been  at  work  and  have  given 
us  a  sure  foundation  upon  which  to  lay,  in  their  proper  order,  the 
facts  gathered  from  observation. 

With  diminished  barometric  pressure  we  have,  of  course,  less 
weight  of  atmosphere  pressing  upon  the  surface  of  the  body,  and 
this  was  long  thought  to  be  important  in  accounting  for  the  phe- 
nomena of  mountain-sickness.  It  has  since  been  shown,  however, 
that  as  the  pressure  from  the  air  within  the  body  is  equally  dimin- 
ished, and  the  laws  regulating  the  diffusion  of  gases  equalize  the 
pressure  throughout  the  body,  there  is  no  direct  practical  effect  from 
diminished  barometric  pressure  per  se,  or  at  least  not  more  than  a 
passing  one.  So,  because  with  the  lessened  amount  of  air  in  each 
cubic  inch  of  atmosphere  there  must  also  be  less  oxygen,  the  con- 
clusion was  wrongly  drawn  that  it  was  the  diminution  in  the  amount 
of  oxygen  which  accounted  for  the  shortness  of  breath  and  other 
phenomena  of  mountain-sickness. 


PHTHISIS. 


109 


As  the  actual  amouot  of  oxygen,  even  at  the  greatest  heights  to 
which  man  has  penetrated,  is  always  in  excess  of  that  required  in 
order  that  the  blood  may  carry  on  its  functions,  this  theory  is  not 
satisfactory.  It  has  been  proved  that  the  deficiency  is  in  the  pro- 
portion of  oxygen  in  each  cubic  foot  of  air  inhaled,  and  not  in  its 
actual  amount.  In  short,  the  special  effects  of  altitude  are  directly 
produced,  not  through  the  influence  upon  the  lungs  and  heart  of  the 
reduced  pressure  of  the  atmosphere  nor  of  the  reduced  amount  of 
oxygen,  but  by  the  reduction  of  oxygen-pressure.  When  air  is  taken 
into  the  lungs  a  certain  proportion  of  the  total  amount  of  oxygen 
contained  in  this  air  is  absorbed  by  the  hsemoglobiu,  which  is  that 
element  of  the  blood  contained  in  the  red  corpuscles,  and  is  the  direct 
receiver  and  carrier  of  oxygen  to  the  system.  As  each  drop  of  haemo- 
globin can  only  take  up  oxygen  in  a  certain  proportion  to  the  oxygen- 
pressure  of  the  air,  it  therefore  follows  that  when  this  oxygen- 
pressure  is  lowered,  as  it  is  in  elevated  climates,  the  newcomer  is 
rendered  uncomfortable  because  his  blood  is  not  sufficiently  oxy- 
genated by  each  ordinary  inspiration.  To  remedy  this  he  breathes 
faster,  so  as  to  take  in  more  air  and  more  oxygen  in  a  given  space 
of  time  ;  the  heart  has  therefore  to  pump  blood  more  frequently  into 
the  lungs,  and  his  pulse  beats  faster.  These  are,  however,  only  the 
immediate  effects ;  in  time  the  chest  becomes  expanded,  so  that  more 
air  is  taken  in  at  each  breath  ;  the  heart  is  increased  in  size,  its  cavi- 
ties hold  more  blood,  and  its  walls  are  thickened  so  that  the  muscle 
has  more  force  to  pump  the  increased  amount  of  blood. 

Blood-chang-es  Produced  by  Altitude.  The  natural  method 
of  compensation  for  the  deficiency  in  oxygen-pressure  does  not  stop 
here,  however,  and  a  still  more  remarkable  change  takes  place,  in 
which  lies  the  special  therapeutic  value  of  high  climates  for  appro- 
priate cases.  This  change  is  an  increase  in  the  amount  of  red 
corpuscles  and  haemoglobin,  whereby  the  oxygen-absorbing  power 
of  the  blood  is  largely  increased,  and  in  a  definite  ratio  to  the 
elevation.  Some  of  the  experiments  which  have  established  these 
facts  will  be  briefly  referred  to. 

Paul  Bert,  on  examining  the  blood  of  the  llama  (the  Peruvian 
mountain-sheep),  found  that  for  every  100  cubic  centimetres  of 
blood  it  absorbed  an  average  of  20  cubic  centimetres  of  oxygen, 
while  the  sheep  of  the  plains  did  not  absorb  more  than  an  average 
of  15  cubic  centimetres  of  oxygen  ;  Viault,  Muntz,  and  others  re- 
peated and  confirmed  these  experiments. 


110  MEDICAL  CLIMATOLOGY. 

That  the  increase  in  the  number  of  red  corpuscles  and  haemo- 
globin is  due  to  the  diminished  atmospheric  pressure,  and  not  to  the 
other  accompanying  conditious,  was  proved  by  Regnard,  who  at  sea- 
level  placed  a  rabbit  under  a  bell-glass  and  reduced  the  atmospheric 
pressure  until  it  was  equivalent  to  an  altitude  of  9500  feet.  Two 
bell-glasses  were  used,  so  that  the  rabbit  could  be  changed  from 
one  to  the  other  when  cleaning  and  disinfecting  became  necessary. 
The  rabbit  was  kept  in  this  atmosphere  for  a  month,  aud  then 
came  out  fat  and  healthy.  Examination  of  its  blood  showed  that 
it  absorbed  21  cubic  centimetres  of  oxygen,  while  under  normal 
conditions  its  blood  and  that  of  its  fellows  at  sea-level  could  only 
absorb  17  cubic  centimetres  of  oxygen.  These  changes  in  the  respi- 
ratory capacity  were  completed  in  about  four  weeks. 

At  the  Congress  fiir  innere  Medicin,  held  at  Wiesbaden,  April, 
1893,  Dr.  Egger  read  a  valuable  paper  upon  ""  The  Blood-changes 
in  High  Mountains."  He  began  by  referring  to  the  experiments  of 
Viault  made  at  Merococha,  Peru  (altitude,  14,275  feet),  upon  six  per- 
sons, by  which  he  found  that  after  they  had  ascended  above  sea-level 
and  remained  three  weeks  the  number  of  red  corpuscles  had  increased 
from  five  millions  to  eight  millions.  He  then  passed  on  to  detail  his 
own  experiments,  made  during  the  summer  of  1891  at  Arosa  (alti- 
tude, 5500  feet),  upon  twenty-seven  persons,  twenty-one  men  and  six 
women.  In  every  case  there  was  a  marked  increase  of  blood-cor- 
puscles, the  average  increase  being  16  per  cent.,  aud  it  was  greater 
in  tuberculous  than  in  sound  persons.  The  diet  and  the  general 
conditions  of  daily  life  were  the  same  which  had  been  habitual  to  the 
patients  at  home.  Like  experiments  upon  nine  rabbits  showed  17  per 
cent,  increase.  The  increase  was  permanent,  as  the  blood  was  retested 
in  several  cases  some  months  later,  aud,  further,  the  blood  of  ten 
natives  showed  the  same  average  in  the  number  of  red  corpuscles, 
viz.,  seven  millions.  Experiments  upon  six  rabbits  also  demon- 
strated the  fact  that  the  increase  was  not  in  the  capillaries  or  cuta- 
neous vessels  alone,  but  that  it  was  universal,  being  found  also  in  the 
carotid  and  femoral  arteries. 

Egger  proved  further  that  the  increase  was  not  due  to  the  evapora- 
tion of  the  serum  in  the  drier  air  of  the  high  ground  and  a  consequent 
increase  in  blood-density  and  in  the  relative  number  of  corpuscles, 
but  was  an  actual  increase.  He  established  this  by  withdrawing 
blood  from  two  rabbits  on  low  ground,  at  Basle,  treating  it  with 
the  hsematocrit,  and  performing  the  same  experiment  three  weeks 


PHTHISIS.  ni 

later,  upon  the  same  rabbits  after  transferring  them  to  the  high 
ground  of  Arosa.  He  found  that  the  percentage  of  solid  con- 
stituents in  the  blood  examined  was  practically  the  same  on  high 
as  on  low  ground.  In  five  persons,  three  men  and  two  women,  resi- 
dent in  Basle,  who  were  suffering  from  marked  oligocythsemia — i.e., 
scarcity  of  red  corpuscles — there  was,  after  a  few  weeks'  change  to 
Arosa,  an  increase  in  this  respect  from  five  millions  to  six  millions, 
and  their  disease  was  cured.  He  found  also  that  in  healthy  persons 
who  returned  from  Arosa  to  low  ground  the  number  of  red  cor- 
puscles became  normal  again  in  three  weeks,  and  in  the  case  of  those 
who  were  anaemic  that,  while  they  lost  their  increase,  the  number 
of  corpuscles  did  not  again  fall  below  the  normal. 

He  also  made  experiments  for  haemoglobin,  using  FleischPs  hsemo- 
globinometer  modified  somewhat  by  Miescher.  In  eleven  persons, 
a  month  after  their  transferrence  to  Arosa  from  sea-level,  he  found, 
without  exception,  16.35  per  cent,  increase  of  haemoglobin,  and 
the  same  was  shown  in  three  rabbits.  He  noted,  however,  that  the 
haemoglobin  increased  much  more  slowly  than  the  corpuscles.  As 
this  is  exactly  what  takes  place  after  a  hemorrhage,  when  there  is  a 
rapid  increase  of  red  corpuscles  followed  by  a  gradual  increase  of 
haemoglobin,  he  believes  it  to  be  an  additional  proof  that  altitude 
increases  the  actual  amount  of  both  corpuscles  and  haemoglobin,  and 
that  it  is  no  mere  relative,  apparent  increase,  but  a  real  one. 

Muntz,  by  experiments  upon  rabbits  at  sea-level  on  the  Pic  du 
Midi  (9000  feet),  found  that  the  specific  gravity  of  the  blood  was 
increased  by  altitude,  as  was  also  the  amount  of  iron.  Viault,  in 
the  year  1890,  conducted  similar  experiments  (also  on  the  Pic  du 
Midi),  the  results  of  which  were  confirmatory  of  those  made  by 
Muntz. 

Egger,  in  closing,  said  that  the  one  important  factor  in  the  causa- 
tion of  these  changes  is  the  diminished  oxygen-pressure,  and  that 
the  crucial  experiment  was  made  by  liegnard  when  he  proved  that 
if  barometric  pressure  was  decreased,  the  blood's  power  of  absorption 
of  oxygen  was  increased. 

At  the  same  congress  Drs.  Koeppe  aud  Wolf  also  reported  upon 
the  blood-changes  produced  by  altitude.  Their  experiments  were 
made  between  Leipsic,  near  sea  level,  and  Reiboldsgriin  (elevation, 
2200  feet).  They  found,  in  experiments  upon  healthy  and  sick 
persons,  especially  among  the  latter,  a  marked  increase  in  the  number 
of  red  corpuscles,  a  marked  reduction  of  haemoglobin,  "  a  striking 


112  MEDICAL  CLIMATOLOGY. 

behavior  in  the  proportion  of  blood-plates,  and  a  unique  appearance 
in  them,"  These  changes  remained  constant  after  the  eighth  or 
ninth  day.  On  comparing  notes  with  those  who  had  experimented 
at  different  altitudes  their  conclusion  that  the  number  of  corpuscles 
increased  in  proportion  to  the  altitude  was  corroborated.  They 
stated,  further,  that  the  size  of  the  new  corpuscles  is  smaller  than 
that  of  the  old,  and  that  they  are  not  so  rich  in  haemoglobin.  These 
physicians  consider  that  the  facts  justify  the  belief  that  altitude 
increases  tissue-change,  and  is  of  special  value  to  consumptives. 
Egger  noticed  that  while  the  corpuscles  increased  19.72  per  cent, 
daring  the  first  twelve  days'  residence  on  high  gronnd  the  hsemo- 
globiu  increased  only  7.23  per  cent.;  but  in  the  next  twenty-four 
days,  while  the  corpuscles  increased  only  4  per  cent,  more,  the 
haemoglobin  increased  8  per  cent.  The  fact  that  Koeppe's  cases 
were  observed  for  an  average  of  but  fourteen  days,  while  Egger's 
were  observed  for  an  average  of  thirty-six  days,  partially  explains 
Koeppe's  evident  error  in  stating  that  the  haemoglobin  was  not  in- 
creased. His  experiments  were  not  so  elaborate  nor  so  precise  as 
those  of  Egger,  and,  with  respect  to  the  increase  of  haemoglobin,  his 
conclusions  are  opposed  to  those  of  all  other  observers  and  conflict 
with  reasonable  deduction.^ 

We  see,  then,  that  the  following  facts  are  established,  namely, 
that  the  peculiar  eff'ects  of  high  altitudes  are  to  increase  the  number 
of  red  corpuscles  in  the  blood  and  also  the  amount  of  haemoglobin, 
as  well  as  the  power  of  oxygen-absorption.  The  chest-expansion  is 
also  increased,  this  fact  being  admitted  by  all  observers,  who  have 
also  remarked  frequently  upon  the  almost  emphysematous  character 
of  the  breathing  (especially  at  the  apices  of  the  lungs)  of  native-born 
children  and  old  residents. 

With  regard  to  the  assumed  enlargement  of  the  heart-cavities  and 
heart-muscle  no  sufficiently  precise  or  extensive  experiments  have  as 
yet  been  made  to  prove  what  logical  deduction  and  common  belief 
indorse,  viz.,  physiological  cardiac  hypertrophy.  The  remarkable 
power  of  horses  raised  in  high  altitudes  to  endure  prolonged  fatigue 
and  great  speed,  both  in  their  native  uplands  and  also  when  trans- 
ferred to  the  sea-level,  is  a  matter  of  common  observation  and  belief. 
The  superior  endurance  of  mountaineers  is  also  well  known.  This 
has  been  especially  noted  by  Hirsch  in  accounting  for  the  endurance 

1  The  more  recent  experiments  of  Lopez  in  Mexico  confirm  the  statements  of  Egger,  as  do 
also  those  of  Fraenkel,  Gebhard,  and  Gravitz. 


PHTHISIS.  113 

of  natives  resident  in  the  high  Ancles.  Further,  tlie  results  of  the 
treatment  of  heart-disease  by  the  strengthening  effect  of  climbing 
and  by  residence  in  high  altitudes,  as  recommended  by  Oertel,  tend 
to  coufirm  the  belief  that  the  normal  heart  (and  sometimes  the  ab- 
normal heart  also)  is  increased  both  in  strength  and  capacity  by 
altitude. 

We  have,  then,  as  the  especial  physiologic  effects  of  altitude,  act- 
ing through  barometric  pressure,  greater  lung-capacity,  as  shown  by 
the  increased  chest-expansion  and  more  forcible  breath-sounds,  a 
stronger  and  larger  heart,  and  an  increased  ability  of  the  blood  to 
absorb  oxygen.  Therefore,  we  have  good  reason  to  believe  that 
there  is  developed  a  greater  power  of  resistance  to  the  lodgement 
of  germs  within  the  body  through  the  increased  germicidal  char- 
acter of  the  more  highly  oxygenated  blood,  as  well  as  through 
the  more  perfect  working  of  the  lungs  and  heart.  We  may  also 
assume  that  there  is  an  equalizing  of  the  circulation  throughout  the 
body,  and  that  the  tendency  to  local  stagnation — that  is,  to  chronic 
congestion — is  thereby  lessened.  On  the  other  hand,  the  more 
vigorous  circulation,  if  by  an}j  accident  it  should  be  dammed  up  at 
any  point,  would  cause  a  more  violent  local  inflammation  and  a 
greater  general  fever  and  disturbance.  This  is  shown  in  acute 
pneumonia,  a  disease  more  severe  on  high  ground  than  at  sea-level 
under  otherwise  similar  conditions. 

In  connection  with  these  changes  in  the  blood  and  its  circulation 
and  in  the  respiration,  and  ocL'urring  at  the  same  time,  certain 
peculiar  effects  upon  the  nervous  system  have  been  noted;  but  as 
this  phase  of  the  question  has  not  yet  been  fully  developed,  and  as 
it  does  not  affect  the  main  points  of  the  discussion,  we  will  not  here 
do  more  than  refer  to  it,  although  we  know  that  it  must  largely 
modify  the  influence  of  altitude. 

General  Therapeutic  Effects.  Turning  now  to  consider  briefly 
how  the  results  of  observations  on  the  effects  of  altitude  upon  dis- 
ease agree  with  the  physiological  facts,  proved  and  inferred,  we 
find  that  better  results,  as  a  rule,  are  obtained  at  high  than  at  low 
altitudes  in  all  diseases  of  which  anaemia  or  any  other  deficiency  of 
the  blood  is  the  most  important  feature,  and  also  in  chronic  germ- 
diseases,  such  as  tuberculosis,  provided,  of  course,  that  in  either  case 
the  accompanying  conditions  are  not  of  a  nature  to  be  seriously 
aggravated  by  altitude. 

Thus  it  is  true  that  cases  of  pure  ansemia,  or  those  in  which  the 


114  MEDICAL  CLIMATOLOGY. 

anfemia  is  the  controlling:  factor  (as  in  most  cases  of  neurasthenia 
and  cases  of  pure  or  mixed  tuberculosis),  without  grave  complications 
from  catarrhal,  inflammatory,  irritable  nervous,  or  cardiac  condi- 
tions, are,  as  a  rule,  most  markedly  benefited  by  residence  in  a  high 
climate.  As  might  be  expected  from  the  equalization  of  the  circula- 
tion before  referred  to,  the  tendency  to  hemorrhage  is  lessened  ;  but 
when  it  occurs  the  bleeding  is  often  more  profuse.  Many  chronic 
heart-affections  and  aneurisms  are  benefited,^  while,  on  the  other 
hand,  to  cases  where  the  disease  is  too  far  advanced  to  admit  of 
improvement  there  is  great  danger  in  high  climates. 

Returning  to  the  question  of  the  assumed  increase  of  the  germi- 
cidal power  of  the  blood,  it  should  be  stated  that  physiologists  have 
not  as  yet  proved  it  by  experiments;  but  certain  clinical  observa- 
tions strengthen  a  belief  in  its  existence.  For  instance,  when 
typhoid  fever,  scarlet  fever,  measles,  etc.,  prevail  at  high  altitudes 
they  are  much  more  frequently  of  a  mild  type  than  in  low  clim- 
ates, and  the  symptoms  are  often  so  slight  as  to  be  unrecognized, 
showing,  doubtless,  that  the  germs  are  scanty  and  well  resisted.  But 
along  with  these  mild  cases  there  are  seen  now  and  again  some  of  the 
most  severe  types;  indicating  apparently  that  when  the  attack  has 
been  caused  by  an  unusual  quantity  of  germs  even  the  especially 
strong  germicidal  power  of  the  blood  is  overcome  and  the  disease 
progresses  uncontrolled.  This  occurs  in  the  outset,  at  least ;  though,  if 
death  does  not  ensue,  the  increased  power  of  resistance  returns  and 
the  convalescence  is  more  rapid  and  complete  than  is  usual  at  sea- 
level.  This  increased  germicidal  quality  of  the  blood  is  shown,  I 
believe,  in  many  ways,  as,  for  instance,  the  comparative  difficulty 
in  making  successful  vaccinations  at  high  altitudes  and  the  rarity  of 
hydrophobia. 

I  will  now  briefly  refer  to  the  effect  produced  by  some  of  the 
elements  of  elevated  climates,  other  than  diminished  barometric 
pressure,  which  they  share  in  common  with  certain  of  the  climates 
of  low  altitu  'e.  While  there  may  or  may  not  be  less  precipitation, 
there  is  almo:i  invariably  a  drier  atmosphere,  as  shown  in  the  smaller 
degree  of  hun  di.y,  both  relative  and  absolute,  and  there  is  usually  a 
dry,  well-drai.  .^  soil.  This  quality  of  dryness  lessens  the  effect  of 
the  temperature  rpon  the  body  by  increasing  the  evaporation  from 
the  skin  and  lungs,  aud  consequently  such  affections  as  sunstroke  are 

1  Arc.)     '    S-nith's  observations  in  the  Andes  confirm  these  statements. 


PHTHISIS.  115 

rare.  lu  nervous  disorders,  while  neuralgia  accompanied  by  anaemia 
is  not  common,  the  various  myalgias  and  dry  pleurisies  are  frequent, 
and  inflammatory  and  irritable  conditions  and  disturbances  of  nervous 
equilibrium  are  not  unusual.  As  might  be  expected,  the  dryness  im- 
proves the  action  of  the  skin,  mucous  membranes,  bowels,  liver,  etc., 
in  one  class  of  individuals  while  it  disturbs  it  in  another.  The 
dry  air  further  increases  the  nerve-tension  of  the  individual  and 
also  the  electric  phenomena  of  the  atmosphere. 

In  summer,  warm,  dry  air,  by  increasing  evaporation,  lessens  the 
injurious  effect  of  heat  upon  the  body ;  and  in  winter,  on  the  other 
hand,  the  cold,  although  it  chills  the  surface  of  the  body,  does  not 
materially  affect  the  heat  maintained  throughout  the  system,  because 
dry  air  is  a  non-conductor. 

As  in  dry  air  little  vapor  is  interposed  between  the  body  and  the 
sun's  rays,  the  latter  have  more  power,  both  as  to  heat  and  light, 
than  in  most  climates  of  low  altitude,  and  therefore  the  vivifying 
effects  upon  animal  life  are  strongly  exhibited ;  but  the  air  itself, 
which  is  unusually  cold  in  the  shade  and  at  uight,  because  there  is 
little  vapor  to  retain  the  warmth,  mitigates  the  injurious  influence  of 
too  great  a  degree  of  heat. 

Effects  upon  Sanitation.  The  increased  sunlight  and  sun-heat, 
with  the  increased  electric  tension  and  consequent  increased  ozone, 
insure  a  normally  pure  air  and  a  readier  destruction  of  germs 
which  are  conveyed  into  it  from  the  bodies  of  sick  persons  or  ani- 
mals or  from  garbage  or  filth.  Thus  it  is  found  that  the  tubercle- 
bacilli  in  sputum  are  more  quickly  destroyed,  and  infection  more 
rarely  follows  even  when  the  conditions  are  otherwise  favorable; 
but  it  must  be  remembered  that  out  of  the  body  as  in  it,  if  for 
any  reason  the  number  of  germs  is  excessive,  the  barriers  due  to 
altitude  are  swept  away,  and  infection  will  be  as  sure  and  fatal 
as  in  low  countries.  Therefore,  while  it  is  reasonable  to  believe 
from  the  facts  and  logical  assumptions  that  both  the  -body  and  the 
air  are  better  protected  against  injurious  germs  at  .11  altitude,  and 
that  these  germs  are  feebler  and  less  abundant,  yet  ifhen  the  safety- 
line  is  once  passed  the  pestilence  will  walk  and.'^thO  body  wither  as 
surely  on  the  mountain  as  the  plain.  The  mbuii  bineer  may  trifle 
longer  with  the  laws  of  health  and  sanitation ^than  the  plainsman; 
but  if  he  does  not  mend  his  ways,  the  day  of  reckoning  will  surely 
come. 

In  all  climates,  whether  at  high  or  low  altitude"'       3  law    )f  health 


116  3IEDICAL  CLIMATOLOGY. 

must  be  obeyed.  To  preserve  the  body  in  a  state  of  resistance  and 
keep  the  home  sanitary,  both  must  be  clean,  and  pure  air  and  sun- 
shine must  be  freely  admitted.  Where  these  precautions  are  taken 
no  other  germicides  are  needed  nor  will  infection  be  rife.  During  the 
tweuty-two  years  of  my  practice  in  Colorado  Springs  my  colleagues 
aud  myself  together  have  only  been  able  to  collect  some  twenty  cases  of 
phthisis  which  had  originated  in  the  town  (population  about  22,000), 
aud  this  in  spite  of  the  fact  that  the  hygienic  conditions  of  some  of 
the  poorer  parts  of  the  city  are  very  indifferent. ^^^_     '  , 

1  On  this  point  see  article  by  C.  F.  Gardiner,  M.D.,  in  tlie  American  Journal  of  the  Medical 
Sciences. 


CHAPTER  VII. 

FORMS  OF  PHTHISIS  AS  INFLUENCED  BY  CLIMATE. 

In  order  to  comprehend  fully  tlie  effect  of  climate  npou  phthisis 
it  is  necessary  to  remember  not  only  that  consumption  is  a  germ- 
disease,  but  also  that  it  is  more  or  less  connected  with  inflammatory 
and  catarrhal  states  of  the  respiratory  tract,  and  that  it  is  usually 
complicated  by  anaemia. 

For  our  purpose  we  will  find  it  convenient  to  divide  phthisis  into 
three  forms — the  tuberculous,  the  pneumonic,  and  the  catarrhal. 
While  each  form  is  accompanied  by  more  or  less  inflammation  or 
catarrh,  and  eventually  becomes  tuberculous,  yet  in  their  inception, 
and  usually  throughout  their  course,  either  the  tuberculosis,  the  in- 
flammation, or  the  catarrh  is  the  most  prominent  feature.  For  this 
reason  the  form  of  phthisis  has  much  to  do  with  its  relative  preva- 
lence in  the  various  climates  and  also  with  the  selection  of  the 
appropriate  climate  for  a  developed  case. 

Being  a  germ-disease,  phthisis,  as  we  might  expect,  develops  less 
readily  in  a  cold  climate  than  in  a  warm  one,  provided  it  be  dry;  and 
when  established  its  advance  is  more  rapid  in  a  hot  climate. 

In  view  of  the  fact  that  its  origin  is  often  catarrhal,  we  are  not 
surprised  that  it  prevails  less  and  is  oftener  cured  in  climates  which 
are  dry  rather  than  damp.  Further,  in  view  of  its  dual  character 
as  both  a  germ  and  a  catarrhal  disease,  a  cold,  dry  climate  is  rather 
better  for  it  than  a  hot,  dry  climate,  and  a  cold,  moist  climate  worse 
than  a  hot,  moist  climate. 

In  order  to  bring  out  these  points  most  strongly  the  extremes  of 
climate  have  been  spoken  of,  but  in  actual  therapeutic  application 
only  moderate  climates  are  used.  Therefore,  those  referred  to  are 
the  warm  and  cool,  the  dry,  but  not  the  excessively  dry,  and  the 
moist,  but  not  the  extremely  damp. 

As  a  broad  statement  it  may  be  said  that  the  majority  of  purely 
tuberculous  cases  undoubtedly  do  best  in  cool,  dry  climates  and 
next  best  in  warm,  dry  ones;  on  the  other  hand,  the  inflammatory 
cases  do  best  in  warm,  moist  climates  and  next  best  in  warm,  dry 


118  MEDICAL  CLIMATOLOGY. 

ones ;  while  the  catarrhal  cases  do  best  iu  a  warm,  dry  atmosphere 
and  next  best  in  a  warm,  moist  one. 

Elevated  climates  are  far  more  beneficial  than  low  ones  for  the 
majority  of  cases  of  phthisis,  and  particularly  for  the  more  purely 
tuberculous  form,  as  they  afford  greater  relief  to  the  aneemia  which 
is  usually  present. 

The  victims  of  the  purer  tuberculous  type  are  found  mostly 
among  those  in  whom  the  lungs  are  poorly  developed  or  imper- 
fectly used.  A  cool,  dry  air  is  beneficial  to  this  class  of  invalids, 
because  the  cold  air  is  more  bracing  and  stimulates  to  more  exercise 
and  to  greater  consequent  lung-expansion  and  use ;  also  to  larger 
appetite  and  an  improvement  in  the  quality  of  the  blood.  While 
the  dryness  prevents  the  depressing  effects  of  the  cold  and  causes 
more  evaporation  from  the  lungs  and  a  quickening  of  tardy  circula- 
tion, it  also  increases  the  nerve-tension,  and  therefore  makes  respira- 
tion and  all  other  functions  more  active.  The  dry,  cool  air  also 
tends  to  relieve  chronic  congestion,  particularly  of  the  lungs,  and 
to  cure  anaemia.  Moreover,  in  such  a  climate  exercise  is  enjoyable 
because  of  the  coolness  and  because  the  opportunities  for  taking  it 
in  the  outer  air  are  frequent  and  pleasant,  there  being  a  scarcity  of 
precipitation  and  cloudiness  and  an  abundance  of  sunshine. 

On  the  other  hand,  the  inflammatory  or  pneumonic  type,  which 
is  generally  found  in  persons  of  an  irritable  circulation  and  nervons 
system  and  of  a  full  habit,  is  in  danger,  in  cool,  dry  air,  of  an  over- 
stimulation of  the  lungs,  and  the  increased  evaporation  may  cause 
the  tissues  to  become  charged  with  salts,  which  form  an  additional 
source  of  irritation.  Then,  again,  iu  this  type  the  circulation  and 
nervous  system  cannot  stand  the  unusual  stimulation,  and  there  is 
great  danger  of  a  fresh  pneumonia  being  developed,  so  that  a  warm, 
moist  climate,  where  the  effects  are  of  a  sedative  nature,  is  preferable. 

The  catarrhal  cases,  on  the  contrary,  usually  do  better  in  a  warm, 
dry  air,  because  the  dryness  tends  to  lessen  the  secretion  from  the 
mucous  membrane,  and,  combined  with  the  warmth,  acts  as  a 
moderate  stimulant,  mitigating  at  the  same  time  the  danger  of 
catching  cold. 

The  Individual  in  Climatotherapy. 

In  considering  the  personal  equation  in  the  question  of  climatic 
change  for  an  invalid,  and  particularly  for  a  consumptive,  I  shall 


FORMS  OF  PHTHISIS  AS  INFLUENCED  BY  CLIMATE.     119 

avail  myself  largely  of  the  studies  1  made  upon  this  subject  and  pre- 
sented before  the  Colorado  State  Medical  Society/  and  also  of  an  ad- 
dress upon  temperament  given  before  the  Denver  Medical  Association.^ 

The  question  which  I  desire  to  bring  to  the  attention  of  the  reader 
is  the  influence  which  the  conduct  and  temperament  of  the  consump- 
tive exert  upon  the  progress  of  his  disease.  We  all  of  us  doubtless 
believe  that  the  degree  of  prudence  and  intelligence  shown  by  the 
invalid  in  regulating  his  life  greatly  modifies  the  result;  and,  fur- 
ther, that  his  general  physique  and  his  temperament  are  important 
elements  in  determining  improvement  or  deterioration.  Nothing, 
however,  has  been  done,  so  far  as  I  can  ascertain,  to  demonstrate  by 
statistics  the  proportionate  influence  of  wisdom  and  unwisdom,  of 
the  quality  of  the  physique,  and  of  the  special  kind  of  temperament. 
The  difficulty  in  correctly  classifying  each  case  and  the  difference 
among  observers  both  as  to  definition  and  in  ability  to  read  the  signs 
of  each  quality,  have  doubtless  tended  to  discourage  attempts  in  this 
direction  ;  and  at  the  best  it  must  be  admitted  that,  in  dealing  with 
many  cases,  a  large  margin  must  be  allowed  in  the  exact  figures  given 
for  the  precise  influence  of  such  factors  as  conduct  and  temperament. 
It  is  only  when  the  main  points  are  agreed  upon,  the  material  plenti- 
ful, the  observers  many,  and  their  opportunities  of  judging  of  these 
personal  matters  frequent  and  lasting  through  a  good  portion  of  the 
period  of  illness  that  such  facts  can  be  arrived  at.  It  is  not  the  con- 
sultant, ignorant  of  the  patient's  daily  history  and  seeing  him  but 
once  or  twice,  who  can  determine  how  far  over-exercise  or  sloth, 
apathy  or  worry,  lack  of  physical  resistance  or  excess  of  reaction  has 
been  displayed  during  the  months  or  years  of  the  sickness,  so  as  to 
bring  the  patient  correctly  under  the  special  denominations  used  in 
the  classifications  which  follow ;  it  is  for  the  physician  in  charge  to 
furnish  the  facts  upon  which  such  matters  can  be  determined. 

Admitting  that  it  is  possible  to  produce  a  rough  scheme  of  classi- 
fication out  of  elements  so  indefinite  and  complex,  and  then  to 
demonstrate  the  influence  of  each  class,  it  may  be  asked,  Ou,i  bono  f 
The  answer  is  that  although  we  are  probably  correct  in  our  general 
common-sense  views  of  these  subjects,  and  although  we  usually  in- 
fluence our  cases  so  as  to  mitigate  the  various  evils  arising  from  the 
diiferent  elements,  yet,  if  it  be  well  to  believe  rightly,  it  is  still  better 
to  know  correctly,  even  though  in  each  case  the  consequent  treat- 

1  Transactions,  1891.  =  Journal  of  the  American  Medical  Association,  June  8,  1889. 


120  MEDICAL  CLIMATOLOGY. 

ment  be  the  same.  Further,  our  patients  will  hearken  to  us  the 
more  when  we  can  speak  to  thein  to  the  effect  that  the  percentage  of 
improvement  is  much  greater  among  wise  iuvalids  than  among  the 
foolish,  who  perish  through  their  own  folly  in  the  proportion  shown 
by  the  statistics  of  so  many  thousand  cases.  The  physician,  also, 
if  he  knows  the  relative  percentage  of  danger  lurking  in  a  special 
physique  or  temperament,  is  forewarned  and  so  forearmed,  and  can 
shape  his  treatment  and  his  prognosis  with  greater  accuracy. 

With  these  objects  in  view  I  have  further  analyzed  the  141  cases 
of  phthisis  treated  by  me  in  Colorado  which  I  reported  to  the 
American  Climatological  Association.^  The  cases  are  too  few  in 
number  to  enable  us  to  take  the  results  as  absolute  proof  of  any  of 
the  points  inquired  into,  and  these  statistics  can  be  received  only 
as  foreshadowing  in  a  greater  or  less  degree  the  nature  of  the  truths 
to  be  verified  and  elaborated  by  longer  and  ampler  investigations. 

Temperament.  Looking  carefully  through  the  original  notes 
of  my  141  cases,  and  recalling  mental  pictures  of  each  individual, 
their  mental  and  physical  peculiarities,  and  the  tendencies  exhibited 
in  the  reaction  of  each  individual  to  his  surroundings,  I  find  it  com- 
paratively easy  to  range  them  under  the  several  temperaments  which 
I  have  described  in  the  paper  on  this  subject  before  referred  to.  In 
order  to  explain  my  views,  I  quote  the  following  extracts  : 

The  ancient  writers  upon  our  art  endeavored  to  explain  these  dif- 
ferent underlying  forces  as  due  to  certain  humors  ;  the  history  and 
description  of  their  views  are  too  well  known  for  me  to  recapitulate 
them  here.  We  moderns  have  accepted,  and  must  still  accept,  much 
of  their  nomenclature;  but  we  have  rejected  their  explanations  of 
the  causes  of  the  several  temperaments  without  seriously  troubling 
ourselves  to  find  new  ones.  A  writer,-  in  reviewing  two  essays  of 
Hellwig  upon  temperament,  says  : 

'' Physicians  learn  consciously  or  unconsciously  to  recognize  tem- 
peramental differences,  and  suit  both  manner  and  medicine  to  the 
fact."  He  further  goes  on  to  remark  that  the  best  definition  has 
been  given  by  Miiller,  who  essentially  describes  temperament  as 
''the  reaction  of  the  individual  to  his  environment."  In  the  same 
article  is  presented  Hellwig's  tabular  definition  of  the  term  founded 
on  the  view  that  it  is  the  varying  strength  of  the  reception  of  an 
impression,  and  of  the  reaction  of  the  individual  to  it,  that  charac- 
terizes temperament. 

1  Transactions,  1890.  2  The  Medical  Record,  August  4, 1888. 


FORMS  OF  PHTHISIS  AS  INFLUENCED  BY  CLIMATE.     121 
Hellwig's  Table. 


Temperament. 

Reception. 

Reaction. 

Choleric, 

Strong, 

Strong, 

Sanguineous, 

Strong, 

Feeble, 

Melancholic, 

Feeble, 

Strong, 

Lymphatic. 

Feeble. 

Feeble. 

What  is  the  essential  quality  of  living  matter?  Its  power  of 
renewal — that  is,  nutrition.  When  a  portion  of  elementary  living 
matter  which  we  term  protoplasm  becomes  separate  anrl  individual, 
as  iu  an  amoeba,  what  is  the  essential  quality  of  its  individuality  ?  It 
is  its  capacity  to  receiv^e  an  impression  from  and  its  power  to  react 
to  its  environment.  This  quality  is  exercised  through  nerve-force. 
It  is  true  that  we  cannot  detect  nerve-structure,  as  we  know  it,  in 
the  dawning  life  of  the  individual ;  but  though  the  localized  and 
visible  machinery,  which  we  term  nerve-tissue,  is  not  apparent,  the 
real,  essential  element  of  nerve-force  is  undoubtedly  diffused  through 
the  general  mass  of  the  individualized  protoplasm,  conferring  on  it 
the  capacity  to  receive  impressions,  at  least  in  an  elementary  manner. 

The  first  reaction  of  the  separate  piece  of  protoplasm  to  the  recep- 
tion of  an  impression  received  from  its  environment  would  appear 
to  be  the  formation  of  a  cell-wall,  showing  that  it  reacts  to  external 
pressure  by  hardening  itself  superficially.  Thus  it  defines  its  indi- 
viduality and  protects  itself  in  the  exercise  of  its  essential  function 
of  nutrition,  which  consists  of  the  importing  of  raw  material  for  food 
and  converting  it  into  the  structure  of  the  individual.  The  first 
evidence  of  the  existence  of  a  nervous  system  is  in  receiving  and 
reacting  to  impressions  made  from  without;  the  passing  food  is  drawn 
in  when  reflex  action  is  developed  by  the  impression  received  from 
without. 

Thus  we  see  that  a  living  individual  has  two  essential  qualities 
— nutrition,  whereby  it  lives,  and  innervation,  whereby  it  individu- 
alizes itself — each  essential  to  the  other. 

The  evolution  of  nutrition  is  briefly  thus  :  simple  absorption  and 
assimilation  of  food  by  the  whole  mass  of  protoplasm  and  the  gen- 
eral excretion  of  its  waste  ;  then  the  localization  of  digestion  in  a 
stomach  ;  next  the  carrying  of  the  digested  nutriment  to  remote 
parts  by  lymphatic  vessels ;  then  this  circulatory  process  elaborated 
into  a  vascular  system,  with  its  heart  or  pump.  Then  a  portion  of 
the  clear,  white  lymph  gradually  changed  into  red  blood,  then  the 
chemical  changes  producing  bodily  heat.      Thus  the  circulatory  sys- 


122  MEDICAL  CLIMATOLOGY. 

tern  of  nutrition  passes  from  a  lymphatic,  cold-blooded  state  to  the 
warm,  red-blooded  form  seen  in  the  mammal. 

The  nervous  system  develops  first  in  the  sympathetic  form,  next 
the  motor,  then  the  sensory,  up  to  its  highest  elaboration  in  the  brain 
of  man,  with  its  power  of  receiving  impressions  without  bodily  contact 
by  means  of  thought. 

Through  innervation  comes  the  power  to  receive  impressions  made 
upon  the  individual. 

Through  nutrition  comes  the  power  of  reacting  to  such  impres- 
sions, the  latter  being  exhibited  immediately  through  its  circulatory 
system,  which  in  man  in  its  most  important  form,  with  respect  to 
the  power  of  reaction,  is  sanguineous. 

The  essential  difference  in  reception  is  in  speed,  and  it  is,  there- 
fore, classed  in  individuals  as  quick  or  slow.  Quick  reception  may 
be  better  characterized  as  "  nervous,"  and  slow  as  "  phlegmatic." 

The  essential  difference  in  reaction  is  in  strength ;  it  may  be 
classified  as  strong  or  weak.  Strong  reaction  may  be  called  "  san- 
guineous"; weak,  "lymphatic". 

Temperaments  should  be  primarily  divided  into  groups  according 
to  the  receptive  powers,  those  in  which  the  reception  is  quick  being 
denominated  ''nervous,"  and  those  in  which  it  is  slow,  "phleg- 
matic"; according  to  the  pow'cr  of  reaction,  they  would  fall  under 
the  heads  "sanguineous,"  or  those  in  w4iich  reaction  is  strong,  and 
''lymphatic,"  or  those  in  which  it  is  weak. 

An  individual  born  with  a  certain  temperament  can  undoubtedly 
modify  it  considerably  by  force  of  will  and  education.  Circum- 
stance or  disease  will  also  modify  and  temporarily  or  permanently 
change  the  relative  force  of  its  phenomena.  Change  of  climate  often 
exaggerates  or  diminishes  certain  of  its  manifestations.  The  im- 
pression made  upon  temperament  by  disease  is  what  chiefly  con- 
cerns us  as  physicians.  The  reception  of  the  impression  made  by 
the  invasion  of  the  body  by  disease  is  quick  or  slow,  excited  or 
calm,  according  as  the  individual  is  of  the  nervous  or  phlegmatic 
temperament,  and  reaction  is  strong  or  weak  as  he  is  of  the  san- 
guineous or  lymphatic  temperament.  Knowing  the  temperamental 
type  of  a  patient,  we  can  explain  and  allow  for  many  of  the  incon- 
gruities of  pulse,  temperature,  and  nervous  phenomena  that  we  meet 
with. 

How  are  we  to  diagnose  the  temperament?  Is  the  individual 
plethoric  or  anaemic  in  appearance,  finely  chiselled   in  feature  and 


FORMS  OF  PHTHISIS  AS  INFLUENCED  BY  CLIMATE.     123 

small-boned,  or  coarse  in  outline  and  large-boned  ?  Is  he  mentally 
quick  or  slow  in  conversation  and  nervous  or  phlegmatic  under  our 
examination  ?  Is  his  view  of  his  case  exaggerated  in  its  despond- 
ency or  cheerfulness  ?  Does  his  history  show  a  tendency  to  in- 
flammation or  to  passive  congestion  ?  Is  he  inclined  to  fever  ? 
Does  he  react  quickly  to  cold  ?  Are  his  feet  usually  warm  ? 
These,  suggestively,  are  some  of  the  observations  and  questions 
which  will  give  us  the  material  for  classifying  a  patient's  tempera- 
ment. 

The  old  classification  of  temperaments  into  hot  and  cold  suggests 
the  sanguineous  or  hot  and  full-blooded,  the  lymphatic  or  cold  and 
thin-blooded.  The  old  forms  of  dry  and  moist  are  suggestive  of 
the  nervous  and  phlegmatic,  high  nerve-tension  and  dryness  being 
necessarily  allied,  while  moisture  and  low  nerve-tension  are  equally 
inseparable. 

It  is  perhaps  best  to  speak  of  the  peculiarities  of  reception  as 
grouped  under  two  kinds  of  temperament,  viz.,  the  nervous  tem- 
perament, in  which  the  reception  is  quick,  the  phlegmatic,  in  which 
the  reception  is  slow;  as  regards  the  power  of  reaction,  it  may  be 
classed  under  one  of  two  heads,  viz.,  strong  physique  and  weak 
physique.  On  this  basis  I  analyzed  141  cases  of  phthisis  treated  by 
me  in  Colorado,  as  shown  in  the  following  table  : 

Table  showing  Proportion  of  Cured  and  Benefited  in  the 
Different  Temperaments,  in  all  Stages  of  the  Disease. 

Cured,     Benefited,       Cured,        Benefited, 


Temperament. 
Phlegmatic, 

Physique. 
Strong, 
Weak, 

per  cent. 
59 
13 

per  cent. 
86 
47. 

per  cent. 
41 

per  cent. 
70 

Nervous, 

Strong, 
Weak, 

45 
18 

68) 
62  i 

37 

60 

Strong  physique. 
Weak 

both  nervous  and  phi 

egmatic 

49 
19 

84 
57 

We  find  from  this  table  that  the  greatest  number  cured  and  bene- 
fited is  among  those  possessing  a  strong  physique  irrespective  of 
the  temperament;  while,  as  to  temperaments,  the  phlegmatic  are 
more  benefited  than  the  nervous,  providing  they  each  possess  a 
strong  physique;  but,  on  the  other  hand,  when  the  physique  is 
poor  those  with  a  nervous  temperament  show  a  greater  power  of 
resistance  to  the  disease  than  the  phlegmatic. 

"Wisdom  and  Unwisdom.  To  find  out  in  a  measure  what 
amount  of  influence  the  prudence  and  common-sense  of  the  indi- 


124  MEDICAL  CLIMATOLOGY. 

vidual  exerted  over  the  course  of  the  disease,  I  went  carefully  over 
the  records  and  marked  down  each  person  as  wise  or  unwise,  in 
the  matter  of  taking  care  of  himself,  and  then  found  that  of  the  141 
cases  86,  or  61  per  cent.,  were  wise,  and  55,  or  39  per  cent.,  were 
unwise.  I  then  proceeded  to  find  out  the  percentage  of  wisdom  in 
the  various  temperaments,  and  this  is  shown  in  the  appended  table: 

Table  shoaving  the  Proportion  of  Wisdom  amokg  the  Various 

Temperaments. 


i 

I 


Wise. 

Wise. 

Phlegmatic 

1  Strong,  82  per  cent.  ] 
■  i  Weak,  53     "      "      1 

76  per  cent. 

Nervous  . 

f  Strong,  62  per  cent.  ] 
■  t  Weak,  57     "      "      1 

60     "      " 

Strong,  both 

nervous  and  phlegmatic 

.     67     "      " 

Weak,      " 

(1           ii            (< 

.     56     "      " 

From  this  it  appears  that  the  greatest  amount  of  wisdom  was 
among  those  of  a  phlegmatic  temperament,  and  that  there  was  more 
among  the  strong  than  the  weak  ;  therefore,  those  of  a  phlegmatic 
temperament  and  a  strong  physique  were  by  far  the  most  apt  to 
show  wisdom. 

Finally,  I  found  the  percentages  of  cured  and  benefited  among 
the  wise  and  unwise  in  the  first-stage  cases  only ;  then  in  the 
second  and  third  stages  combined  ;  and,  lastly,  in  all  stages  to- 
gether, heading  each  table  with  the  average  percentage  for  the 
total  141  cases,  so  as, to  show  the  relative  effect  of  wisdom  upon 
the  results  : 

Table  showing  Proportion  of  Cured  and  Benefited  among  Wise 
AND  Unwise  in  the  Different  Stages. 

r  Total,  141  cases, 
1st  stage      i  Wise  cases, 

i  Unwise  cases, 
2d  and  3d    (  Total,  141  cases, 

stages      ■{  Wise  cases 
combined    l  Unwise  cases, 
All  stages    f  Total,  141  cases, 

combined      ^^'^^  ^^««^' 

t  Unwise  cases, 

From  these  tables  it  would  appear  that  among  the  wise  the  per- 
centage of  cures  in  all  stages  was  a  third  more  than  the  average 


Cured. 
58  per  cent. 
68     "      " 
31     "      " 

Benefited. 
87  per  cent. 
91     "      " 
75     "      " 

14  per  cent. 

21     "      " 
2     "      " 

52  per  cent. 
59     "      " 
41     "      " 

33  per  cent. 
42     "      " 
11     "      " 

68  per  cent. 

77     "      " 
51     "      " 

F0B3IS  OF  PHTHISIS  AS  INFLUENCED  BY  CLIMATE.     125 

and  nearly  four  times  as  many  as  among  the  unwise;  and  the 
percentage  of  those  benefited  was  similarly  higher,  though  in  a 
less  degree.  In  the  first  stage  a  like  difference  prevailed,  but  in 
both  the  cured  and  benefited  in  a  degree  about  50  per  cent,  less  ; 
while,  taking  second  and  third  stages  and  omitting  the  first-stage 
cases,  the  difference  was  similar,  but  among  the  cures  very  much 
more  marked  in  this  than  in  the  other  tables.  This  would  indicate 
that,  although  imprudence  is  a  bad  thing  in  an  early  stage,  it 
is  far  more  serious  in  an  advanced  one,  in  which  an  act  of  folly 
is  often  irremediable.  The  superiority  of  results  among  the  pru- 
dent serves  to  explain  in  a  measure  the  better  reports  obtained  from 
sanitariums  than  from  open  resorts,  a  fact  which  is  demonstrated 
by  my  tables  in  the  article  upon  Climate,  already  referred  to,  for 
doubtless  the  example  and  the  discipline  enforced  in  sanitariums 
turn  many  of  the  would-be  unwise  into  wise  invalids. 

Conclusions.  If,  as  would  appear  from  the  comparison  made 
with  the  other  reports  of  cases  treated  in  climates  of  high  altitude, 
these  141  cases  represent  the  average  qualities  of  such  cases,  then 
the  truths  indicated  by  these  inquiries  are  that  the  qualities  which 
most  aid  the  consumptive  in  recovery  are,  first,  strength  ;  secondly, 
wisdom;  and,  thirdly,  equability  of  temperament. 

Therefore,  the  essentials  of  the  general  treatment  of  phthisis  are  to 
preserve  and  strengthen  the  physique,  to  enforf^e  prudence,  and  to 
induce  placidity. 


CHAPTER  VIII. 

RESULTS  OF  THE   TREATMENT  OF  PHTHISIS  BY  CHANGE  OF 

CLIMATE. 

In  order  to  ascertain  as  far  as  possible  what  are  the  definite  effects 
of  change  of  climate  upon  the  progress  of  phthisis,  I  have  searched 
the  medical  libraries  and  press  as  thoroughly  as  my  opportunities 
allowed.  The  total  number  of  cases  which  I  found  reported  in 
such  shape  that  they  could  be  tabulated  for  the  purpose  of  com- 
parison was  7795.  The  number  of  separate  reports  was  thirty-six 
and  the  number  of  individual  observers  twenty-four.  Beside  the 
above-mentioned  reports,  the  statistical  results  of  which  will  be 
found  in  the  table  on  pages  132  and  133,  there  were  twelve  reports 
by  seven  additional  observers ;  these  are  given  in  the  foot-notes,  but 
could  not  be  introduced  into  the  tables,  and  they  complete  the  sum 
total  of  all  reports  with  statistics  which  I  could  find. 

The  material  from  which  the  statistics  are  compiled  was  extracted 
mainly  from  the  pages  of  the  masterly  and  exhaustive  treatise  upon 
The  Diseases  of  the  Lungs,  by  the  late  Dr.  Wilson  Fox,  while  I  am 
also  indebted  to  Dr.  Hermann  Weber's  Climatotherapy ;  to  the  late 
Dr.  C  T.  B.Williams's  work  upon  Pulmonary  Consumption;  to  Dr. 
C.  Theodore  Williams's  Aerotherapcutics ;  to  Diseases  of  the  Lungs, 
by  the  late  Dr.  Walshe ;  to  the  late  Dr.  Austin  Flint's  work  on 
Phthisis;  to  Dr.  Charles  Denison's  Rocky  Mountain  Health-resoi^ts ; 
to  the  Transactions  of  the  American  Climatological  Association,  and 
various  reports  of  hospitals  and  sanitariums. 

In  such  a  disease  as  phthisis  it  must  be  obvious  that  the  ma- 
terial of  which  the  cases  are  composed  is  too  variable  in  quality 
and  tendency  to  allow  any  close  comparison  of  results.  The  most 
convenient  and  practical  division  of  phthisis  is  into  three  stages — 
the  first  stage  being  that  of  infiltration,  with  more  or  less  consolida- 
tion of  the  lung-tissue,  but  no  softening ;  the  second  stage  that 
in  which  softening  has  commenced,  but  no  cavities  can  be  detected  ; 
and  the  third  stage  that  in  which  cavities  are  present.  These 
divisions,  based  on  the  local  state  of  the  disease,  are  used  by  the 


TREATMENT  OF  PHTHISIS  BY  CHANGE  OF  CLIMATE.     127 

majority  of  the  reporters.  The  same  terms,  however,  are  frequently 
applied  not  so  much  to  the  local  as  to  the  general  condition  of  the 
patients,  for  it  is  recognized  that  the  disease  may  be  in  the  first  stage 
locally,  and  yet  its  extent  or  its  accompanying  serious  symptoms  be 
such  that  the  condition  of  the  patient  as  regards  any  prospect  of 
cure  must  rank  with  the  second  or  tliird  stage  of  the  disease.  In 
short,  while  the  tuberculosis  may  locally  be  limited  or  incipient,  or 
may  not  have  proceeded  to  the  stage  of  softening,  yet  the  phthisis, 
with  its  general  disturbance  of  the  health  and  waste  of  the  system, 
may  be  far  advanced.  On  the  other  hand,  softening  or  cavities 
may  be  well  marked  and  even  extensive,  while  the  phthisis  is  com- 
paratively slight  or  non-progressive,  so  that  the  case  may  be  in  a 
distinctly  higher  class,  viewed  as  material  for  climatic  cure.  Again, 
the  three  stages  are  sometimes  used  chiefly  to  define  the  length  of 
the  time  during  which  the  disease  has  existed;  while  it  is  perhaps 
true  that  the  majority  of  first-stage  cases  are  recent — that  is,  early 
or  incipient — yet  some  cases  remain  in  the  first  stage  for  years  and 
some  never  pass  beyond  it,  although  they  continue  to  ?how  symp- 
toms of  pulmonary  tuberculosis  or  phthisis.  Also  softening  and 
even  excavation  may  occur  very  early  in  the  case,  but  if  the  patient 
show  power  of  resistance,  both  local  and  general,  the  disease  tends 
toward  self-limitation,  and  so  the  case  may  offer  more  encouraging 
material  for  climatic  relief  than  one  where  the  disease  is  in  the  first 
stage  or  is  of  more  recent  origin. 

Heredity,  physique,  temperament,  and  circumstance,  as  well  as 
accompanying  complications,  modify  considerably  the  quality  of  the 
case,  under  whatever  stage  the  disease  may  be  grouped ;  Avhile  the 
temperament,  accuracy,  reliability,  education,  and  experience  of  the 
reporter  also  influence  the  value  of  any  single  set  of  statistics.  It 
is  therefore  impossible  to  gauge  the  reports,  one  by  another,  and  to 
make  exact  comparisons. 

The  value  of  the  climate  also  varies  with  the  particular  season,  and 
passing  influences,  such  as  previous  epidemics  of  influenza,  modify 
the  general  character  of  the  phthisis  exhibited  by  patients  during 
particular  periods  of  observation.  Thus  we  see  that  it  is  impossible 
to  make  close  comparisons  of  the  influence  of  each  variety  of  climate 
upon  phthisis,  either  upon  the  disease  as  a  whole  or  its  various  stages. 

We  have,  however,  in  the  relatively  imperfect  and  heterogeneous 
statistics  available  and  here  presented,  a  fund  of  recorded  observa- 
tions formed  by  the  laborious  industry  of  men  of  character  and  ex- 


128  MEDICAL  CLIMATOLOGY. 

perience,  and  it  would  be  a  grievous  pity  if,  instead  of  putting  this 
talent  out  at  interest,  we  were  to  wrap  it  in  a  napkin  and  wait  for 
the  fulfilment  of  a  dream,  when  all  reports  shall  be  uniform  and  all 
reporters  exact  and  we  shall  be  able  fully  to  comprehend  and  classify 
cases  of  phthisis  and  climates  in  all  their  bewildering  variations  and 
intricacies. 

Fortunately  every  shield  has  another  side,  and  if  we  turn  from 
that  on  whose  face  we  fail  to  see  order,  "  heaven's  first  law,"  we 
may  clearly  discern  on  the  reverse  side  another  law,  the  law  of  aver- 
ages. In  the  use  of  this  law  the  very  widespread  diversity  of 
opinions,  ability,  opportunity,  material,  and  season  comes  as  an  aid 
instead  of  a  hindrance,  and  enables  us  to  find,  in  the  place  of  nice 
comparisons,  governing  principles,  and  so  we  gain  some  insight 
into  the  why,  wherefore,  and  whither  of  these  varied  and  some- 
times incongruous  statements.  It  is  necessary  therefore  to  arrange 
these  reports  in  groups,  in  which  are  given  a  sufficient  number  of 
reports  and  reporters  to  equalize  the  variations  and  to  afford  a  fair 
average;  thus  comparisons  can  be  made  which,  it  is  reasonable  to 
believe,  indicate  in  a  general  way  the  relative  values  of  the  several 
varieties  of  climates  in  the  treatment  of  phthisis. 

The  conclusions  drawn  from  the  statistics  are  confirmed  or  modi- 
fied by  what  we  may  regard  as  reasonable  deductions  from  our 
knowledge  of  the  ])hysiological  and  other  influences  of  climate,  and 
by  other  statistics  which  show  the  geographical  distribution  of  the 
disease. 

Statistics  of  Results  of  Change  of  Climate.  In  this  spirit  I 
have  set  out  all  the  statistical  iuformation  that  could  be  obtained, 
which  was  sufficiently  complete,  in  the  tables,  grouping  each  case 
according  to  its  stage,  because  this  is  the  best  common  ground 
for  classification,  although  it  is  an  imperfect  one.  It  will  be 
seen,  however,  that  the  separation  has  only  been  carried  out  in  a 
portion  of  the  original  reports,  and  therefore  the  variety  and  number 
of  reports  in  mauy  of  the  groups  are  not  sufficient  to  indicate  clearly 
the  general  influence  of  the  group  in  this  particular  stage. 

The  second  and  third  stages  were  so  frequently  combined  in  the 
original  reports  that  it  seemed  best  to  unite  them  in  the  table. 
In  consequence  of  the  different  definitions  of  the  stages  and  the 
scarcity  of  material  under  each,  it  is  undoubtedly  true  that  the 
results  under  the  head  of  all  stages  are  most  reliable,  for  it  is  very 
unlikely  that  patients  should  be  set  down  as  consumptives  unless 


TREATMENT  OF  PHTHISIS  BY  CHANGE  OF  CLIMATE.     129 

they  are  so,  whereas  the  exact  stage  reached  by  the  disease  is  much 
more  easily  mistaken.  By  thus  combiuing  all  stages  a  sufficient 
number  of  cases  is  obtained  to  produce  an  average  quality  all  round. 

With  respect  to  results,  the  definitions  of  the  terms  "  cured," 
'*  arrested,"  "  partially  arrested,"  "  greatly  improved,"  "  improved," 
'^  stationary,"  etc.,  are  so  varied  that  I  thought  it  best  simply  to 
group  under  ''  benefited  "  all  the  cases  which  the  reporter  did  not 
classify  as  '^  stationary,"  "  worse,"  or  "  died."  Here,  again,  it  is 
only  the  breadth  and  depth  of  the  inquiry  that  save  it  from  being 
useless,  because  the  length  of  time  during  which  the  patient  was  under 
observation,  and  at  the  end  of  which  the  given  result  was  reached, 
varied  greatly.  For  instance,  many  reports  coming  from  local 
physicians  at  health-resorts  are  made  on  the  condition  of  the  patient 
at  the  end  of  the  season  and  at  the  sanitarium  when  the  patient 
leaves  ;  while  in  my  own  statistics  I  do  not  report  upon  any  case 
which  I  have  seen  for  the  first  time  within  two  years  of  making 
the  report  of  results.  This  allows  a  better  opportunity  of  judging 
of  the  permanency  of  results.  Most  of  my  reports,  of  course, 
dated  much  further  back.  Again,  some  physicians  attach  most 
importance  to  the  local  improvement  and  some  to  the  general,  so 
that  the  material  from  several  reporters  must  be  combined  in  order 
to  get  a  fair  average  in  this  respect. 

Group  I.  Home. Climates.  England  can  scarcely  be  said  to  illus- 
trate change  of  climate,  as  nearly  half  the  cases  were  still  in  the  same 
city  (for  instance,  most  of  those  treated  at  Brompton  Hospital),  and 
in  the  other  cases  the  climatic  change  was  comparatively  trifling, 
England  is  introduced,  however,  as  a  home  climate,  for  the  purpose 
of  comparison,  as  showing  the  difference  to  a  consumptive  in  remain- 
ing at  home  and  in  going  to  a  different  climate.  England  is  the 
only  country  from  which  such  reports  were  available  ;  but  home 
climates  where  the  prevalence  of  phthisis  is  about  the  same  would 
probably  show  figures  approximating  to  these. 

Group  II.  Ocean-voyages.  This  group  is  not  so  extensive  as 
it  should  be,  either  in  the  number  of  cases  reported  or  in  the 
number  of  observers,  particularly  as  the  course  and  season  of  each 
voyage  varied  so  much.  Patients  sent  on  voyages  are  generally 
carefully  selected,  and,  according  to  Dr.  "Williams,^  while  they  often 
improve  in  appearance  and   in  general  well-being,  they  frequently 

1  Aiirotherapeutics. 


130  MEDICAL  CLIMATOLOGY. 

show  an  advance  in  the  local  disease.  Most  of  the  cases  here  re- 
ported took  a  voyage  from  England  to  Australia  or  the  Cape. 

Group  III.  Island  Climates.  These  embrace  seven  reports  and 
568  cases,  of  which  all  but  25  were  from  Madeira.  The  first-stage 
cases  appear  to  have  done  remarkably  well,  though  no  doubt  there 
are  other  sea  islands  less  moist  and  relaxing  which  would  give  better 
reports  for  all  stages. 

Group  IV.  Coast  Climates  are  represented  by  Riviera  resorts 
alone.  The  number  of  cases  is  greater  than  in  any  other  group 
(2328  cases),  and  they  are  given  by  four  reporters.  It  is  to  be 
regretted  that  no  reports  can  be  given  of  the  coast  climates  of 
Southern  California,  as  they  are  very  similar  to  the  climate  of  the 
Riviera  and  have  been  extensively  used  by  consumptives. 

Group  V.  Land  Climates  of  Low  Altitude  are  represented  by  the 
Adirondacks,  Aiken,  Southern  California,  Asheville,  Rome,  and 
Pau,  making  a  total  of  789  cases  by  seven  reporters.  The  value  of 
the  total  percentage  of  these  reports,  viewed  sim[)ly  as  an  illnstration 
of  the  influence  of  climate,  is  somewhat  modified  by  the  inclusion  of 
the  reports  of  sanitariums  at  Saranac,  Sharon,  and  Asheville.  At 
Saranac  and  Sharon  the  patients  are  selected,  aud  this,  coupled  with 
better  care  and  less  danger  from  imprudence  than  falls  to  the  lot  of 
the  average  patient  living  in  the  same  climate  outside  the  sanita- 
rium, probably  raises  the  percentage  of  benefit  over  what  it  other- 
wise would  be.  The  greater  elevation  of  Saranac  and  Asheville 
over  the  open  resorts  may  also  aid  in  bringing  about  better  results. 
Omitting  the  sanitarium  reports  from  this  group  the  percentage  of 
benefit  is  only  58. 

Group  VI.  Desert  Climates  of  Low  Altitude.  Egypt  and  Syria 
are  the  only  countries  (in  which  a  desert-air  is  the  chief  feature 
of  the  climate)  from  which  reports  could  be  obtained.  The  num- 
ber of  cases  is  small — 154  in  all — and  the  number  of  observers  only 
three.  From  my  personal  experience  in  Egypt  and  similar  climates 
the  percentage  would  appear  to  me  lower  than  it  should  be.  These, 
though  they  come  under  the  general  head  of  land  climates  of  low 
altitude,  are,  because  of  their  greatly  increased  dryness  and  sunshine, 
put  in  a  separate  group. 

Group  VII.  Climates  of  High  Altitude.  These  are  all  well  repre- 
sented by  reports  of  the  cases  of  2027  patients  who  resided  in  the  Alps 
and  571  who  were  treated  in  Colorado,  making  a  total  of  2598. 
The  Alps  had  five  reporters  and  Colorado  four.      No  reports  could 


TREATMENT  OF  PHTHISIS  BY  CHANGE  OF  CLIMATE.     131 

be  obtaiuerl  from  other  high  climates.  The  Alpine  percentage  for  all 
stages  is  3  per  cent,  higher,  which  slight  difference  is  apparently  due 
not  to  any  superiority  of  climate,  but  to  a  higher  percentage  of  first- 
stage  cases  in  the  Alpine  than  in  the  Colorado  reports  (Alps  60  per 
cent,  in  the  first  stage,  and  Colorado  only  40  per  cent.). 

It  is  probable  that  the  cases  were  also  better  selected  and  the 
patients  more  prudent. 

I  may  add  that  the  percentage  in  Dr.  Fisk's  100  and  my  250 
cases  is  lower  than  the  average,  because  a  longer  time  was  allowed 
to  elapse  before  the  reports  were  made  than  is  the  case  with  the 
other  observations  given.  However,  the  remarkable  approximation 
in  results  obtained  by  most  of  the  nine  separate  reporters  would 
indicate  the  general  correctness  of  the  observations. 


132 


MEDICAL  CLIMATOLOGY. 


Table  showing  Reported  Results  of  Climatic  Change  in  7795 
Cases  of  Phthisis. 


All  stages. 

1st  stage. 

2d  and  3d  stages. 

Climates. 

No. 

of 

cases. 

Benefited. 

No. 

of 

cases. 

Benefited. 

No. 

of 
cases. 

Benefited. 

No. 

Per  ct. 

No. 

Per  ct. 

No. 

Per  ct. 

1.  Home  Climates. 
England : 

London.  Williams^     .    . 
Brompton  Hosp.,  1st  Rep .2 

700 
535 

210 
150 

30 
28 

235 
187 

98 
75 

42 
50 

465      112 
348        75 

26 
22 

Total 

1235 

360 

29 

422 

173 

30 

41 

813 

24 
17 

187 

23 

2.  Ocean  Climates. 

Voyages.   Williams^ .... 

Flint* 

Webers 

"        Fabero 

65 
13 
19 
26 

45 
7 
9 
5 

70 
54 
47 
19 

41 
"9 

73 

15 

63 

Total 

123 

66 

54 

41 

30 

73 

24         15 

1 

63 

3.  Island  Climates. 

3a.  Madeira.  Williams"      .    . 

Lund*    .... 

.,         f  Mittemaier     I  g 

iGoldschmidt  /"' 

"           Btompton  Hos.'" 

Renton'i    .    .     . 

63 

100 

281 

20 
79 

543 

33 

54 

157 

9 
30 

283 

53 
54 

56 

45 
39 

48 

37 

5 
35 

37 

37 

0 
31 

77 
100 

0 

88 

52 

244 

15 
44 

17 

120 

9 
0 

31 

49 

60 
0 

Total 

52 

125 

105 

84 

355  '     146 

1 

41 

36.  Teneriffe,  St.  Helena,  West 
Indies.    Williams'-    .    . 
Corsica,  Sicily,  Malta,  Cor- 
fu, Cyprus.  Williamsi3_ 

7 
18 

568 

2 
10 

12 

295 

28 
55 

355 

Total 

48 

— 
105 

84 

Islands — total .     . 

52 

125 

146 

41 

4.  Coast  Climates. 

Riviera.  Sparksi* 1930  1196 

Boltiniis 125  28 

Weberiii 63  i      30 

Williamsi'   ....  210  1     115 


Total i  2328     1309 


56 

36 

120 

30 
25 
77 

212 

132 

5.  Lowland  Climates. 
5a.  Open  Resorts : 

Aiken.    Geddings's .    .  69 

South  Calif.    Jonnsou'-'  i  6 

Rome.    Williams-'J  .    .  ,  18 

Pau.    Williams"  ...  43 


Total 136 


42 

61 

4 

67 

4 

3 

10 

55 

21 

52 

77 

57 

4 

3 

75 


186 


TREATMENT  OF  PHTHISIS  BY  CHANGE  OF  CLIMATE.     133 


Climates. 


All  stages. 

2^Q        Benefited, 
of'    —' 
'*^®^|   No.     Perct. 


56.  Sanitariums : 

Sharon,  Mass  Bowditch^a 
Adirondacks  Trudeau^s. 
Asheville,N.C.  Von  Ruek'^* 


Total 


Lowland.s— total , 


6.  Low  Desert  Climates. 

Egypt.  Sandwith^""  .  .  .  . 
Egypt,  Syria.  Williams-^.  . 
Egypt,  Syria.    Weber^'  .    .    . 


40 

559 

54 


653 


789 


Total , 


Low  Desert— total 


104 
26 
24 


154 


7.  High  Climates 

7fx.  Alps.      Weberss  . 

Davos.  Spengler^o 

Williams'* 

Allbutt^i  . 

Rued  1*2    . 


106 

342 

247 

62 

1270 


76.  Colorado.    Denison^s  . 

Fisks*.     .  . 

"  Johnson^o  . 

Sollyss    .  . 


Total 


Altitudes— total  . 


23  I        58 

358  I        64 

34  '        65 


415  64 


492  i        62 


47  76 

953  75 


Total 2027     1551 


202  162 

100  67 

19  15 

250  176 


571 


2598 


420 


1971 


1st  stage. 


2d  and  3d  stages. 


No. 

of 

cases. 


Benefited.     !   jj^    I    Benefited. 
--      of'  — 


No.      Perct. 


No.    Per  ct. 


72 
16 
12 

69 
61 
50 

6 

100 

65 

6 

592 

63 

125 

80 
269 
202 

7.5 
75 
82 

70 
159 

138 
21 


77         251       223 


42 

9 

106 


92 


232 


76     1    483 


22  I      19  I        79  18  4  22 

87         82  94         472       276  .58 

6  6         100  48         28  58 


115 

i 

107 

93 

538 
540 

308 
309 

57 

m' 

110 

92 

57 

18 


8  1        44 


67  18  8  44 


125       114  91     '     558       317 


430 


164 

106 

i   89 

65 

92 
91 

78 
87 

127 
58 
10 

144 

93 

28 
8 
84 

73 
48 
80 
58 

89 

339 



503 

213 

63 

1 

89 

319 

63 

1  C.  B.  Williams  and  C.  T.  Williams:  Med.-Chir.  Trans.,  1871,  vol.  liv.,  table  p.  108;  also 
Trans.,  1872,  vol.  Iv.,  table  p.  241.  Dr.  Wilson  Fox  extracted  from  these  two  reports  all  the 
cases  that  had  remained  in  England  of  which  the  results  were  known— 700  cases.  See  p.  902 
Treatise  on  Disease  of  the  Lungs,  Wilson  Fox,  M.D.    Churchill,  London. 

2  Brompton  Hospital,  first  report.  This  is  the  only  report  which  is  divided  into  stages  ;  the 
other  report  given  by  Wilson  Fox  could  not  be  used  in  this  table. 

3  Voyages:  (C.  T.  Williams)  see  p.  907,  Wilson  Fox. 
<  Voyages:  (Austin  Flint)  Flint  on  Consumption. 

s  Voyages:  (Hermann  Weber)  Braun's  Curative  Effects  of  Baths  and  Waters,  p.  566. 

6  Voyages:  (Faber)  Practitioner,  1877,  vol.  xix.  p.  275. 

7  Madeira :  (C.  T.  Wllliamsi  Med.-Chir.  Trans.,  vol.  Iv. 

8  Madeira :  (Lund)  from  White's  Madeira ;  also  British  Medical  Association  Journal,  1883  : 
also  Theodore  Williams's  Influence  of  Climate  in  Pulmonary  Consumption.  "  It  must  be  noted 
that,  of  the  arrests  of  the  first  stage,  relapses  occurred  in  two.    In  the  second  stage,  of  five 


134  MEDICAL  CLIMATOLOGY. 

cases  of  'arrest,'  relapses,  followed  by  subsequent  arrest,  occurred  in  two;  two  were  much 
ameliorated,  and  in  two  more,  though  the  disease  progressed  to  the  third  stage,  it  was  then 
arrested,  and  the  general  health  remained  good.  I  have  placed  the  four  last  named  among 
'  marked  improvement.'  In  the  third  stage  it  is  stated  of  three  cases  that  on  leaving  after  one 
winter  their  only  symptoms  were  moderate  cough  and  expectoration.  I  have  placed  these 
among  '  relief  or  slight  improvement.'  "    Note  17,  p.  907,  Wilson  Fox. 

8  Madeira :  (Mittemaier  and  Goldschmidt.)  "  Madeira,  seine  Bedeutung  als  Heilungsort. 
37  cases, 'first  stage,  all  recovered  ;  244  second  and  third  stages,  83  recovered,  2  relapsed,  49  were 
living  with  a  mean  of  fourteen  years  subsequently,  14  lost  sight  of,  8  died  later  of  other  dis- 
eases, having  lived  for  a  mean  (?)  of  fifteen  years;  12  died  later  of  phthisis,  having  lived  for  a 
mean  often  and  a  half  years.  These  all,  with  the  exception  of  two  relapses,  are  reckoned  as 
81  cures ;  39  died  after  Uving  variable  periods  up  to  fourteen  years.  These  are  reckoned  as 
'iSlight  improvement.'  but  are  also  included  in  the  total  of  173  deaths,  which  includes  also  the 
12  before  referred  to  among  the  cures."    Note  18,  p.  903,  Wilson  Fox. 

1"  Madeira :  (Brompton  Hospital  report,  1866)  20  patients  were  especially  selected  and  sent 
out  for  the  winter,  but  ou  their  return  the  results  were  considered  so  discouraging  that  the 
experiment  was  not  repeated. 

11  Madeira  :  (Renton)  Edinburgli  Med.  Surg.  Journ.,  1827. 

12  Teneriffe,  St.  Helena,  West  Indies:  (Williams)  Med.-Chir.  Trans.,  vol.  Iv. 

13  Corsica,  Sicily,  Malta,  Corfu,  and  Cyprus  :  (Williams)  Med.-Chir.  Trans.,  vol.  Iv. 
i*  Kiviera  :  (Sparks)  note  10,  p.  902,  Wilson  Fox. 

15  Riviera  :  (Bottini)  Walshe,  Diseases  of  the  Lungs,  see  p.  619.  Bottini  gives  21  arrests  in  the 
first  stage,  and  55.3  per  cent,  improved  ;  taking  the  mean  between  them,  as  in  Williams's  cases, 
it  yields  26  cases  improved  in  both  local  and  general  condition. 

i'5  Riviera  :  (H.  Weber)  Klimato-therapie,  Ziemssen's  Handb.  AUg.  Therapie. 

1'  Riviera  :  (C.  T.  Williams)  Aerotherapeutics,  p.  47.  Williams  gives  a  table  on  page  51  of 
Aerotherapeutics,  with  the  number  of  first  stages  123,  but  3  were  lost  sight  of,  leaving  120.  He 
states  that  these  improved  in  the  proportiori  of  41  to  30  per  cent,  more  than  the  ca-saty  cases, 
but  the  table  and  text  do  not  make  it  clear,  and  there  are  some  typographical  errors.  I  have 
taken  the  highest  number  of  improved  possible,  viz  ,  77  cases. 

18  Aiken  :  (Geddings)  Trans.  Amer.  Climatol.  Assoc. 

19  Southern  California  :  (H.  A.  Johnson)  Trans.  Amer.  Climatol.  Assoc,  1891;  see,  also,  Hare's 
System  Therap.,  vol.  i.  p.  427. 

20  Rome  :  (C.  T.  Williams)  Med.-Chir.  Trans.,  vol.  Iv. 

21  Pau  :  (C.  T.  Williams)  Med.-Chir.  Trans.,  vol.  Iv. 

22  Sharon:  (V.  Y.  Bowditcb)  Med.-Chir.  Trans.,  Amer.  Climatol.  Assoc,  1893. 

23  Adirondacks  :  (E.  L.  Trudeau)  from  ten  annual  reports,  the  last  being  for  1894,  Adirondack 
Cottage  Sanitarium.  The  only  reports  obtained  of  first  stage  were  for  the  years  1890-'92-'93-'94. 
Those  who  remained  less  than  three  months  are  not  included,  as  they  are  in  the  all-stage 
tables,  because  they  are  not  separated  in  Dr.  Trudeau's  report.  He  recently  writes  to  me  that 
the  cases  are  selected  before  admission,  and  again  picked  out  after  three  months'  trial,  only 
hopeful  cases  being  retained. 

2-t  Asheville  :  (Karl  von  Ruck)  Medical  News,  September  16,  1893. 

-•'  Egypt :  (F.  M.  Sandwitb)  Egypt  as  a  Health-resort. 

2«  Egypt  and  Syria  :  (C.  T.  Williams)  -\erotherapeutics,  p.  28. 

27  Egypt  and  Syria :  (H.  Weber)  Klimato-therapie. 

28  Alps  :  (H.  Weber)  Klimato-therapie. 

29  Davos  :  (Spengler)  Wilson  Fox,  note  13,  p.  903. 

30  Davos:  (C.  T.  Williams)  Aerotherapeutics.  p.  111. 

31  Davos:  (Cliflbrd  AUbutt)  Lancet,  1878,  vol.  ii.,  and  1879,  vol.  i.,  and  also  Wilson  Fox,  note 
15,  p.  903. 

32  Davos :  (Carl  Ruedi)  Dr.  Ruedi  very  kindly  gave  me  extracts  from  his  case-books.  He  had 
noted  his  cases  at  the  end  of  each  season  as  improved  or  not ;  he  had  not  divided  the  cases 
into  separate  individual  cases,  but  reported  the  same  persons  as  often  as  they  passed  a  season 
at  Davos.  Dr.  Ruedi's  report  covered  twelve  seasons,  with  1270  cases  (an  unknown  number 
being  repeated),  953  cases  of  these  improved,  thus  making  the  benefited  75  per  cent. 

s-i  Colorado :  (C.Denison)  Rocky  Mountain  Health-resorts.    Houghton,  Mifflin  &  Co.,  Boston 

31  Colorado:  (S.  Fisk)  Trans.  Amer.  Climatol.  Assoc,  1891. 

35  Colorado:  (H.  A.  Johnson)  Trans.  Amer.  Climatol.  Assoc,  1890. 

3«  Colorado:  (S.  E.  Solly)  Trans.  Amer.  Climatol.  Assoc,  1890. 


TREATMENT  OF  PHTHISIS  BY  CHANGE  OF  CLIMATE.     135 
Reports  not  used  in  the  Tables. 

1.  The  second  Brompton  report  of  6001  eases  is  referred  to  by  Dr.  Wilson  Pox,  but,  as  it  is 
not  divided  into  stages  and  does  not  make  evident  the  total  percentage  of  improvement,  I 
have  not  used  it.  The  extent  of  improvement  was  apparently  only  15  per  cent.  (Wilson  Fox. 
p.  902). 

2.  Pollock's  Brompton  report  of  641  cases,  improvement  25.6  per  cent.,  was  not  used,  as 
apparently  some  of  the  cases  appear  in  the  last  Brompton  report  (t'ox,  p.  902). 

3.  Williams  reported  235  cases  who  had  some  climatic  change,  but  as  it  is  not  defined  I 
omitted  these.    The  improvement  was  38.7  per  cent. 

4.  Champouillon  reported  78  cases  who  tried  various  changes  of  climate.  This  is  omitted  for 
the  same  reason,  and  because  the  percentage  of  improvement  is  not  given  (Pox,  p.  902). 

5.  Hameau  reported  110  patients  treated  at  Arcachon ;  improved,  13.6  per  cent.  This  was 
not  used,  as  Arcachon  could  not  be  ranged  with  the  Riviera  group  (Pox,  p.  902). 

6.  Leeson  sent  29  patients  to  the  districts  of  Buenos  Ayres  ;  improved.  48.2  per  cent.  These 
were  omitted,  as  they  could  not  be  put  in  any  group  (p.  904). 

7.  Leeson  sent  23  patients  to  Montreux  ;  improved,  48  per  cent.  Omitted  for  the  same  reason. 

8.  Dettweiler  reported  1022  patients  treated  at  Palkenstein  Sanitarium ;  improved,  25.7  per 
cent.  The  report  does  not  show  the  stages,  and  I  thought  it  fairer  to  omit  it  as  the  percentage 
seems  too  low  (Fox,  p.  904). 

9.  Thaon  reported  151  cases  treated  at  Nice  ;  improved,  55  per  cent.  Omitted  because  appar- 
ently included  in  Spark's  report  (Fox,  p.  904). 

10.  Williams  reported  "  10  cases  treated  in  India  generally."  Much  too  indefinite  climatically 
to  be  used.  Tlie  improvement  was  90  per  cent.  He  reported  four  treated  in  New  Zealand.  75 
per  cent,  improved  ;  also  nine  cases  who  went  to  the  Cape  and  Natal,  58  per  cent,  improved. 
Both  these  are  omitted  f)r  the  same  reasons  as  the  first  (Fox,  p  904). 

11.  Brehmer  reported  on  700  cases  treated  in  his  sanitarium  at  Giirbersdorf,  with  13  per  cent, 
cured  in  all  stages,  and  53  per  cent,  cured  in  the  first  stage.  As  he  does  not  give  the  total 
benefited,  I  could  not  use  this  report  (Hare's  System,  vol.  i.  p.  423). 

12.  Von  Ruck  reports  511  cases  treated  at  Asheville  and  other  places ;  45  per  cent,  improved. 
These  are  not  included,  as  they  could  not  be  put  into  any  one  group.  I  had  previously  sup- 
posed that  they  were  all  treated  in  Asheville  at  his  sanitarium  (Hare,  p.  429). 

It  will  be  seen  that  if  these  omitted  reports  had  been  added  to  the  tables  given,  they  would 
have  somewhat  increased  the  percentage  of  improvement  in  the  high  over  the  low  altitudes, 
and  would  also  have  obscured  the  main  features  of  the  statistics. 

If  we  extract  the  percentages  o£  results  for  all  stages  of  each 
group  and  put  them  in  order,  progressing  from  the  ocean  up  to  the 
high  altitudes,  we  see  an  almost  steady  rise  in  the  percentage  of 
improvement  as  we  proceed  toward  the  highlands,  as  illustrated  by 
the  chart  on  page  136. 

It  will  he  observed  that  the  rise  would  be  uniform  were  it  not  that 
the  results  from  ocean- voyages  run  2  percent,  higher  than  those  from 
the  sea  islands,  ..and  that  the  results  from  the  low  inland  resorts  drop 
back  2  per  cent,  below  the  seacoast  climates.  As  has  been  before 
remarked,  the  selection  of  the  cases  sent  on  sea-voyages  is  usually 
more  carefully  made,  and  their  living  more  out  of  doors  in  a  purer  air 
than  they  would  do  on  shore  may  account  for  this  slightly  better  result. 

The  total  percentage  of  the  low  inland  results  is  lowered  by  those 
of  Rome  and  Pan,  otherwise  they  probably  would  not  have  shown 
the  slight  dropping  back  of  2  per  cent,  below  the  Riviera  reports. 
It  is  very  much  to  be  regretted  that  the  physicians  of  Southern 
California  give  no  reports,  and  also  that  none  can   be  had   from 


136 


MEDICAL  CLIMATOLOGY. 


Thomasville  nor  from  many  other  good  inland  places.  The  iesv 
cases  reported  from  Southern  California  were  not  ou  the  coast,  or 
they  would  have  been  classed  with  the  Riviera  group. 

Analysis  of  7795  Cases  of  Phthisis. 


P.C. 

Home 

Sea 

Loirland                     Hlgldaad 

1                                                          ' 

England 

Ocean 

Island 

Coast 

Lovlund 

Sanitari- 
ums 

Desert 

Altitude 

75 

1 

} 

» 

70 

1 

/ 

65 

y 

60 

/ 

55 

/ 

/ 

50 

1 

--. 

l/ 

45 

40 

1 

35 

1 

30 

1 

25 

i 

Influence  of  Sea-air.  In  making  a  further  analysis  of  the 
reports  it  will  be  seen  that  two  chief  climatic  factors  exert  appar- 
ently the  greatest  influence  upon  the  results,  namely,  sea-air  and 
mountain-air.  If  we  arrange  the  reports  into  three  groups,  the  first 
consisting  of  the  ocean,  the  island,  and  the  coast  climates  (England 
being  omitted,  as  it  does  not  illustrate  climatic  change) ;  the  second 
group,  composed  of  the  low  inland  climates,  with  the  sanitariums 
and  the  desert  climates ;  and  the  third,  formed  of  all  the  high  alti- 
tude reports,  and  then  compare  their  total  percentages  of  benefit,  we 
find  they  range  in  the  following  order  : 

All  stages.  1st  stage.  '2d  and  3d  stages. 

Sea  climates,                        57  per  ct.  71  per  ct.  38  per  ct. 

Inland  climates,                    63        "  92        "  57 

Climates  of  high  altitude,  76       "  89       "  63 


TREATMENT  OF  PHTHISIS  BY  CHANGE  OF  CLIMATE.     137 

This  shows  improvement  as  the  sea-influence  diminishes.  There 
is  an  exception  in  the  first-stage  cases  in  the  second  group,  which 
is  doubtless  due  to  the  special  selection  of  the  cases  before  admis- 
sion to  the  sanitariums  and  to  the  extra  care  taken  of  them  while 
there. 

These  results  of  the  influence  of  sea-air  upan  the  treatment  of 
phthisis  by  climate  are  confirmed  by  the  statistical  facts  concerning 
the  mortality  from  phthisis  as  shown  in  the  tables  of  mortality  in 
cities,  the  phthisical  death-rate  per  1000  diminishing  with  the  dis- 
tance from  the  Atlantic  and  Pacific  coast  to  the  Gulf  of  Mexico. 

Dr.  R.  H.  Curtin,  in  a  paper'  entitled  "  The  Influence  of  Sea-air 
on  Syphilitic  Phthisis,"  states  that  he  has  observed  that  most  cases 
of  phthisis  improve  in  sea-air  during  the  first  month  after  they  are 
brought  under  its  influence,  but  run  down  more  rapidly  afterward. 
He  reports  five  cases  of  syphilitic  phthisis  which  were  all  much 
better  on  the  ocean  than  on  land.  An  interesting  discussion  fol- 
lowed, in  which  Drs.  Bruen,  Bowditch,  Knight,  Shattuck,  Musser, 
Ingalls,  and  Donaldson  took  part,  The  consensus  of  opinion  was 
that  sea-air  was  usually  injurious ;  that  pulmonary  tuberculosis 
sometimes  improved  on  sea  islands  or  on  ocean-voyages  (either 
being  better  than  the  coast) ;  but  that  the  improved  cases  were  those 
in  which  the  catarrhal  element  was  prominent. 

In  a  paper  which  followed  this  discussion  Dr.  Boardman  Reed 
said  that  incipient  phthisis  usually  did  well  up  to  a  certain  point  at 
Atlantic  City,  but  that  the  second-  and  third-stage  cases  did  badly. 
Advanced  heart-cases,  he  thought,  also  did  badly  there,  because  of 
over-stimulation.  On  sea-voyages  the  diet  cannot  be  varied,  and 
sea-sickness  is  sometimes  a  most  serious  complication. 

Influence  of  Altitude.  In  order  to  show  the  influence  of  high 
altitudes  as  compared  with  that  of  low  altitudes  I  have  combined 
all  the  low  altitudes,  viz.,  ocean,  island,  coast,  inland  sanitariums, 
and  desert,  together  and  contrasted  the  total  percentage  with  that 
obtained  in  high  climates.      The  result  is  as  follows  : 


All  stages. 

1st  stage. 

2d  and  3d  stages. 

Low  climates, 

59  per  cent. 

75  per  ceat. 

47  per  cent. 

High  climates, 

76   "       " 

89   "       " 

63   "       " 

This  inquiry  has  clearly  demonstrated  two  things,  viz.:    that  the 
majority  of  consumptives  do  better,  other  things  being  equal,    the 

1  Transactions  of  the  American  Climatological  Association,  1887. 


138  MEDICAL  CLIMATOLOGY. 

further  they  are  removed  from  the  sea,  and  that  they  do  better  in 
high  than  in  low  altitudes,  wherever  situated,  the  difference  in  pro- 
portionate improvement  being  here  exhibited. 

Influence  of  Sanitarium  Treatment  on  Phthisis.  I  have  been 
much  disappointed  in  my  efforts  to  gather  statistics  of  the  results  of 
treatment  in  sanitariums.  The  only  reports  I  received  in  answer  to 
my  requests,  which  were  in  such  form  as  to  be  available  for  fair 
comparison  in  a  table,  were  those  of  Drs.  Trudeau,  Von  Ruck,  and 
Bowditch.  jS[o  statistics  of  Gorbersdorf  and  Falkenstein  of  recent 
date  and  giving  the  information  required  could  be  obtained,  nor 
could  I  gather  any  statistics  from  the  many  other  excellent  sanita- 
riums now  well  scattered  over  the  European  continent  and  the  few 
new  ones  recently  established  in  America. 

In  order  to  make  a  fair  comparison  of  results  obtained  in  cases 
treated  in  open  or  closed  resorts — that  is,  between  patients  who  resided 
in  sanitariums  under  supervision,  and  those  who  lived  in  hotels, 
boarding-houses,  or  private  dwellings  without  much  supervision, 
where  the  surroundings  were  not  especially  adapted  to  their  peculiar 
requirements,  and  their  general  life  and  personal  conduct  were  not 
systematically  controlled  by  a  physician — it  is  necessary  to'  consider 
briefly  the  various  modifying  factors. 

The  quality  of  the  cases  is  the  first  factor  of  importance.  Dr. 
Hermann  Weber,  in  replying  to  my  request  for  assistance  in  ob- 
taining reports  from  European  sanitariums,  writes  that  in  his 
opinion  reports  of  such  results  are  not  satisfactory,  because  sanita- 
riums are  largely  a  last  resort  for  desperate  cases,  and  it  is  most 
difficult  to  get  incipient  cases  to  enter  them  ;  therefore,  a  fair  com- 
parison with  open  resorts  cannot  be  instituted.  This  objection 
would  to  a  great  extent  be  removed  if  the  reports  of  results  were 
grouped  under  the  three  stages  of  phthisis.  In  the  cases  entering 
the  Adirondack  and  Sharon  Sanitariums  the  conditions,  according 
to  the  statements  of  the  physicians  in  charge,  are  exactly  the  re- 
verse, the  patients  being  picked  out  from  a  number  of  applicants  as 
likely  to  recover. 

In  the  Adirondack  Sanitarium,  Dr.  Trudeau  writes  me,  patients 
are  again  examined  after  three  months'  residence  and  only  those  are 
retained  who  have  shown  an  encouraging  tendency  toward  recovery. 
In  his  published  reports  the  patients  who  remained  only  three 
months,  some  of  them  leaving  for  pecuniary  reasons  or  causes  other 
than  failing  health,  are  classed  as  a  separate  group,  but  the  results 


TREATMENT  OF  PHTHISIS  BY  CHANGE  OF  CLIMATE.     139 

are  not  given  under  each  stage.  Thus  the  results  at  Saranac,  in  the 
first  stage,  as  shown  in  ray  own  tables,  are  limited  to  those  cases 
which  had  passed  the  second  weeding  out,  and  are  therefore  perhaps 
abnormally  high. 

The  quality  of  the  cases  taken  into  the  Asheville  Sanitarium 
appears  to  be  not  so  good  as  at  Saranac  aud  Sharon.  Dr.  Von 
Ruck  recently  wrote  me  concerning  this,  as  follows  :  ''My  admis- 
sions are  all  more  or  less  advanced  cases,  aud  we  do  not  get  more 
thau  about  a  dozen  of  an  early  stage  in  the  course  of  the  year. 
Now,  if  an  institution  can  discriminate  and  admit  nothing  but 
favorable  cases,  that  institution  must  necessarily  get  better  percent- 
ages." 

Again,  the  conditions  of  life  of  the  patients  admitted  to  the  Adir- 
ondack and  the  Sharon  sanitariums  are  much  improved  by  the  change 
of  circumstances,  and  this  may  further  account  for  the  particularly 
favorable  results  obtained.  The  patients  are  usually  persons  of 
narrow  means,  formerly  engaged  in  a  sedentary  city-life,  who,  having 
been  transported  into  the  country,  are  compelled  to  lead  an  outdoor 
life  and  enabled  to  enjoy  comparative  luxury  under  improved  hy- 
gienic conditions. 

Tuberculin  was  used  in  a  certain  proportion  of  cases  at  Saranac, 
but  not  at  Sharon,  and  the  results  are  given  separately  (I  have  com- 
bined them  in  my  tables).  The  percentage  of  improvement  was 
slightly  greater  in  the  cases  treated  with  tuberculin.  Dr.  Trudeau 
writes  me  that  he  inclines  to  the  opinion  that,  given  the  proper 
conditions,  tuberculin  is  an  aid  in  specially  selected  cases ;  but  he 
believes  that  it  is  only  of  service  where  the  patient  could  tolerate 
without  fever  a  slight  but  gradual  increase  of  dosage,  and  he  used 
it  in  only  such  cases.  He  goes  on  to  say:  "You  can  see,  how- 
ever, readily,  that  it  may  be  just  because  these  are  insusceptible 
to  tuberculin  that  their  cases  turu  out  well,  and  not  because  the 
tuberculin  brings  about  in  them  an  improvement  in  their  disease  or 
a  more  or  less  marked  degree  of  immunity." 

Dr.  Von  Ruck  used  tuberculin  on  36  out  of  90  cases  treated  in 
his  sanitarium  at  Asheville,  and  these  cases,  according  to  his  report, 
did  extraordinarily  well,  the  benefit  in  all  stages  being  95  per  cent., 
while  in  those  not  treated  with  tuberculin  it  was  65  per  cent.  He, 
also,  does  not  give  it  to  cases  with  fever,  and  in  any  case  administers 
it  only  in  cautiously  increased  doses.  The  greater  improvement  in 
his  tuberculin  cases  may  therefore  be  due  to  the  circumstance  that 


140  MEDICAL  CLIMATOLOGY. 

the  oases  upon  whicli  it  was  used  were  of  better  material,  as  sug- 
gested by  Dr.  Trudeau  with  regard  to  his  own  cases. 

It  is  certain  that  when  febrile  cases  are  omitted  the  most  unfavor- 
able element  is  eliminated  ;  and  if  those  who  do  not  tolerate  tuber- 
culin are  also  removed,  we  have,  in  the  tuberculin  cases,  a  highly 
selected  class.  Acting  on  this  assumption,  I  have  combined  the 
cases  treated  with  and  without  tuberculin.  I  am  inclined  to  the 
opinion  that  the  results  were  not  materially  changed  by  this  moder- 
ate use  of  tuberculin,  either  for  better  or  worse. 

The  results  at  Sharon,  while  not  so  good  as  those  in  the  Adiron- 
dacks  or  at  Asheville,  are  probably  better  than  any  which  could  be 
obtained  outside  the  sanitarium  in  the  same  climate.  In  the  Sharon 
reports  it  is  evidently  the  lack  of  elevation  and  the  proximity  to  the 
sea  that  account  for  the  slight  deficiency,  as  my  visit  to  this  sanita- 
rium convinced  me  that  the  institution  and  the  treatment  were  quite 
up  to  the  best  standard.  In  mv  inspection  of  both  Sharon  and 
Sarauac  I  was  much  struck  with  the  admirable  mauner  in  which  the 
patients  were  made  to  live  outdoors,  and  this  doubtless  helped  to 
account  for  the  good  results  obtained. 

Drs.  Trudeau,  Von  Ruck,  and  Bowditch  all  believe  that  they 
obtain  better  results,  other  things  being  equal,  in  the  sanitarium 
than  outside,  though  they  have  no  figures  for  comparison.  My 
personal  experience  in  sanitarium  treatment,  while  not  sufficient 
to  furnish  statistics,  confirms  this  opinion  ;  and  I  believe  the  great 
hindrance  in  all  climates  to  getting  better  results  is  due  to  the  mis- 
taken repugnance  of  most  well-to-do  patients  to  enter  sanitariums, 
and  the  criminal  apathy  of  the  State  in  neglecting  to  furnish  them 
for  the  poor,  so  that  their  use  is  extremely  limited. 

The  statements  of  Drs.  Trudeau  and  Bowditch,  then,  may  be  said 
to  show  that  in  sanitariums  which  are  designed  for  the  use  of  the 
poorer  class  of  consumptives,  and  in  which  the  charges  are  less  than 
the  cost  of  maintenance  or  merely  cover  it,  the  patients  are  selected 
with  a  view  to  doing  the  most  good  by  admitting,  as  far  as  possible, 
only  curable  cases;  therefore,  the  results  of  treatment  are  above  the 
average  attained  under  otherwise  similar  conditions. 

The  statements  of  Drs.  Von  Ruck,  Weber,  and  others  show  that 
sanitariums  in  which  the  charges  are  higher  and  a  profit  is  made  are 
resorted  to  by  the  desperate  rather  than  the  hopeful  cases,  and  the 
results  are  not  so  good  as  in  the  purely  benevolent  institutions.  My 
observations  as  to  the  influence  of  prudence  upon  the  progress  of 


TREATMENT  OF  PHTHISIS  BY  CHANGE  OF  CLIMATE.     141 

phthisis,  as  detailed  on  page  123,  corroborate  these  opinions  of  the 
value  of  sanitariums. 

If  we  contrast  the  results  of  treatment  in  these  sanitariums  with 
that  in  open  resorts  in  both  high  and  low  altitudes,  we  see  that  the 
sanitarium  results  occupy  an  intermediate  position,  as  shown  in  the 
appended  table,  except  that  the  results  in  the  first  stage  exceed  those 
obtained  in  high  altitudes. 

All  stages.  1st  stage.  2d  and  3d  stages. 

Lowland  climates,  58  per  cent.  71  per  cent.  28  per  cent. 

Sanitariums,  63   "       "  95   "       "  58   "       " 

Highland  climates,  76   "       "  89   "       "  63   "       " 

The  Stage  of  Phthisis  as  Influencing  Results. 

It  will  be  observed,  in  looking  at  the  first-stage  column  in  the 
table.=5,  that  while  the  altitude  results  exceeded  all  others,  except 
those  of  the  sanitariums,  yet  the  first-stage  columns  in  all  the 
reports  were  much  better  in  proportion  than  those  of  the  combined 
stages  or  of  the  second-  and  third-stage  columns.  This  seems  to 
indicate  the  correctness  of  the  common  opinion  that  the  majority  of 
incipient  cases  are  benefited  more  or  less  by  any  climatic  change  as 
they  usually  are  by  any  change  of  treatment.  As  to  the  relative 
permanency  of  the  benefit,  the  evidence  here  produced  shows 
nothing,  nor  was  I  able  to  secure  sufficient  reports  of  arrests  and 
cures  to  make  a  fair  comparison. 

In  a  sense  it  may  be  considered  as  unfortunate  that  first-stage 
cases  are  so  easily  improved,  for  these  reasons.  On  dropping  their 
pursuits  and  changing  their  environment,  by  taking  rest  and  fresh 
air,  and  by  cultivating  better  habits,  their  general  constitution  is  very 
apt  to  improve  and  the  local  signs  recede  or  remain  in  statu  quo. 
As  a  consequence  they,  and  often  their  physicians  also,  look  lightly 
upon  the  attack,  and  the  patients  return  prematurely  to  their  former 
life,  believing  themselves  cured.  Accumulated  evidence,  however, 
both  clinical  and  post  mortem,  proves  how  slow  a  process  is  the  cure 
of  a  tuberculosis,  at  least  of  one  that  has  given  clear  signs,  either 
local  or  general,  to  the  physician  in  charge. 

There  are  probably  quite  a  number  of  persons  who  pass  through 
a  tuberculous  infection  with  so  little  cough  or  other  disturbance  of 
the  general  health  that  they  do  not  even  come  under  the  notice  of  a 
physician,  and  no  phthisis  follows,  but  local  signs  may  be  discovered, 
later  during  life  or  after  death. 


142  MEDICAL  CLIMATOLOGY. 

If  a  patient  goes  away,  gains  flesh,  feels  strong,  loses  his  cough  and 
other  symptoras,  and  his  local  signs  disappear  or  remain  quiescent, 
it  is  very  hard  for  the  physician,  even  if  he  has  sufficient  wisdom 
to  attempt  it,  to  persuade  the  patient  to  change  his  life  or  remain 
longer  away,  and  especially  to  go  to  a  distant  or  unknown  country. 
Thus  the  tide  in  the  affairs  of  phthisis,  which,  taken  at  the  flood, 
leads  on  to  health,  is  lost,  and  the  next  catarrh  or  other  accident 
starts  up  the  smouldering  tuberculosis,  and  from  the  lodgement  it 
has  already  gained  it  advances  wath  much  increased  activity. 

These  second  attacks  are  very  frequently  the  beginning  of  that 
sad  and  tedious  progress  to  the  grave  which  is  made  by  the  health- 
seeker  in  various  climates  and  under  varying  treatment.  This 
progress,  alternately  chequered  with  hopeful  improvement  and  de- 
pressing decline,  is  beyond  the  skill  of  the  physician  or  the  benign 
influence  of  climate.  It  is  as  impossible  to  arrest  the  disease  as  it  is 
to  avert  its  inevitable  termination. 

There  are  incipient  eases  of  phthisis  for  which  a  comparatively 
short  and  slight  change  of  climate  is  all  that  is  needed ;  but  these 
must  be  carefully  selected,  and  after  a  return  home  they  should  be 
watched  for  several  years,  all  their  departures  from  health  promptly 
attended  to,  and  their  daily  hygiene  raised  to  as  high  a  standard  as 
possible. 

In  considering  the  length  and  character  of  climatic  change  for  a 
consumptive,  not  only  the  arrest  of  the  disease  but  also  the  perma- 
nent raising  of  the  standard  of  the  patient's  health  demands  our 
attention  in  order  that  recurrent  attacks  may  be  warded  off. 

Diagnosis.  With  reference  to  the  question  of  the  importance  of 
an  early  recognition  of  phthisis  and  of  constant  watchfulness  after  the 
diagnosis  has  been  made,  I  analyzed  the  last  100  first  examinations  I 
had  made  just  previous  to  instituting  the  inquiry,'  and  I  found  that 
in  52  per  cent,  of  the  cases  diagnosis  and  treatment  had  been  de- 
layed beyond  the  time  when  the  symptoms  were  clearly  developed, 
while  in  48  per  cent,  the  disease  had  been  promptly  recognized  and 
treated.  The  total  average  of  delay  was  two  years.  In  those  in 
whom  the  dia2:nosis  was  made  and  treatment  beg-un  in  sood  season 
the  proportion  of  first-stagers  was  48  per  cent.,  while  in  those  in 
whom  there  had  been  delay  and  neglect  the  proportion  of  those  in 
the  first  stage  was  only  29  per  cent.     The  difference  in  the  percent- 

^  Neglect  of  the  Early  Diagnosis  and  Treatment  of  .Pulmonary  Tuberculosis.    S.  E.  Solly, 
M.D.,  in  Medical  News,  February  4,  1893. 


TREATMENT  OF  PHTHISIS  BY  CHANGE  OF  CLIMATE.     143 

age  of  cures  betweeu  the  first  stage  and  the  combined  second  and 
third  stages,  in  the  high  altitudes  to  which  these  cases  came,  is  as 
follows:  first  stage,  62  per  cent.;  second  and  third  stages,  15  per 
cent.  This  negligence  has  very  serious  results.  In  fact,  it  means 
that  out  of  every  hundred  consumptives  who  are  allowed  to  drift 
into  advanced  disease  only  fifteen  recover,  instead  of  sixty-two,  as 
would  be  the  case  if  there  was  no  neglect. 

Indications  and  Contraindications  in  the  Climatic  Treat- 
ment of  Phthisis.  If  the  foregoing  pages  have  been  studied,  the 
general  principles  by  which  one  should  be  guided  in  selecting  a 
climate  for  a  case  of  phthisis  will  be  apparent;  but  as  a  change  to 
a  high  altitude  is  most  desirable  for  the  majority  of  consumptives 
and  most  dangerous  for  those  who  are  unsuired  for  it,  it  is  best  to 
review  briefly  the  indications  and  contraindications  for  the  use  of 
high  altitudes  in  phthisis.  After  studying  these  it  is  easy  to  deduce 
the  approximate  climate  for  those  unsuited  to  high  ground.  They 
have  been  most  admirably  put  by  Dr.  F.  I.  Knight,  and,  as  he  is 
without  prejudice  in  the  matter,  and  has  also  had  a  remarkably 
successful  and  large  experience  in  the  use  of  high  altitudes  for 
phthisis,  I  believe  I  cannot  do  better  than  give  an  epitome  of  his 
views  :^ 

"  1.  He  limits  the  age  of  those  resorting  to  altitudes  to  fifty  years. 
In  temperament  he  prefers  the  phlegmatic  to  the  nervous  with  an 
irritable  heart,  frequent  pulse,  and  inability  to  resist  cold;  and  with 
the  latter,  he  says,  we  must  be  careful  not  to  include  those  who  show 
nervous  irritability  from  disease,  not  temperament,  as  tliey  are  gen- 
erally benefited  in  high  places.  As  regards  disease,  he  first  con- 
siders cases  of  early  apical  affection  with  little  constitutional  disturb- 
ance, and,  although  these  generally  do  well  under  most  conditions, 
yet  considerable  experience  assures  him  that  more  recover  in  high 
altitudes  than  elsewhere. 

"  2.  Patients  with  more  advanced  disease,  showing  some  consoli- 
dation, but  no  excavation  nor  any  serious  disturbance.  When  both 
the  apices  or  much  of  one  lung  is  involved,  and  the  pulse  and  tem- 
perature are  both  commonly  over  100,  it  is  best  to  begin  with  a  low 
altitude. 

"  3.  Hemorrhagic  cases,  early  cases  with  haemoptysis  and  with- 
out much  fever  or  much  disease,  are  benefited  by  high  altitudes. 

I  Transactions  of  the  American  Climatological  Association,  1888. 


144  MEDICAL  CLIMATOLOGY. 

"4.  Patients  with  advanced  disease,  those  with  cavities  or  severe 
hectic  symptoms,  should  not  be  sent  to  high  altitudes.  A  small, 
quiet  cavity  is  not  a  contraindication  ;  hectic  symptoms  are  contra- 
indications. 

^'5.  Patients  in  an  acute  condition  should  not  be  sent. 

"  6.    Cases  o£  fibroid  phthisis  are  not  suitable. 

"  7.  Convalescents  from  pneumonia  or  pleurisy  are  usually  well 
suited  to  elevated  regions. 

"  8.  Advanced  cases  of  tubercular  laryngitis,  if  good  local  treat- 
ment and  freedom  from  dust  can  be  obtained,  may  do  no  worse 
than  elsewhere. 

"  9.  In  cases  complicated  by  other  diseases  much  care  is  needed. 
Cardiac  dilatation  precludes  high  altitudes ;  so  also  does  hyper- 
trophy for  the  most  part,  though  with  exceptions.  A  cardiac 
murmur  resulting  from  a  long-past  attack  of  endocarditis  with  no 
signs  of  enlargement  or  deranged  circulation  should  not  prevent. 
Nervous  derangements  of  the  heart  are  usually  contraindications. 
In  renal  disease  and  in  chronic  hepatitis  the  local  physicians  claim 
that  benefit  is  often  obtained.  Intestinal  ulceration  does  not  bar 
out,  but  benefit  is  doubtful.  Heredity  to  phthisis  is  no  b.ar  to  high 
altitudes,  but  diabetes  renders  them  objectionable.  Syphilis  is  no 
contraindication,  though  in  phthisis  the  combination  always  makes 
the  prognosis  bad." 

In  the  paper  read  by  me  before  the  American  Climatological  Asso- 
ciation, 1889,  entitled  "  Invalids  Suited  for  Colorado  Springs,"  I 
expressed  very  similar  views.  In  closing  this  chapter  upon  phthisis 
I  will  repeat  some  remarks  I  made  in  addressing  the  Arapahoe 
County  Medical  Association,  December,  1892: 

It  must  especially  be  remembered  that  all  sorts  and  conditions 
of  men  may  become  tuberculous,  and  you  must  study  the  individual 
and  his  circumstances  as  well  as  the  type  and  stage  of  the  disease 
before  you  can  plan  a  rational  and  systematic  scheme  of  treatment 
for  him.  All  this  enters  particularly  into  the  question  of  change  of 
climate.  The  well-to-do,  whose  domestic  ties  permit  it,  are  most 
safely  advised  t)  seek  at  once  the  climatic  changes  best  suited  to 
their  case;  and  where  such  luxuries  as  have  become  necessities  to 
them  can  be  obtained,  providing  that  they  are  or  can  be  brought 
into  a  condition  to  stand  the  change.  There  are  many,  however, 
who,  on  account  of  their  circumstances,  cannot  leave  home,  and 
should  not  be  forced  to  do  so  unless  home-treatment  is  not  succeed- 


TREATMENT  OF  PHTHISIS  BY  CHANGE  OF  CLIMATE.     145 

ing.  Hereditary  cases  should  always  be  sent  away.  In  cases  arising 
where  the  conditions  of  life,  except  the  climatic,  are  good,  the  neces- 
sity for  change  is  clearly  indicated.  Cases  resulting  from  pneumonia, 
pleurisy,  or  bronchial  catarrh,  which  is  slow  in  clearing  up,  should 
also  have  change.  In  the  hereditary  the  change  must  be  permanent; 
in  the  second  group  it  must  often  be  so;  there  are  a  certain  number 
of  cases  that  have  arisen  under  peculiarly  unfavorable  conditions  of 
life,  in  which  removal  would  be  a  hardship,  and  which,  if  they  can 
be  placed  under  good  hygienic  conditions  at  home,  may  often  be 
safely  left,  at  all  events  until  the  physician  has  gained  a  clear  knowl- 
edge of  the  tendencies  of  the  case.  Those  also  in  whom  the  tuber- 
culosis is  not  advanced  or  active,  and  whose  depression  of  health 
appears  to  be  due  to  digestion  or  other  causes  which  can  be  equally 
well  treated  at  home,  may  remain  if  they  are  carefully  watched  for 
a  time. 

Often  a  change  to  a  different  house  or  soil  or  different  surround- 
ings, physical  or  social,  will  start  a  patient  on  the  road  to  recovery, 
if  conjoined  with  other  wise  measures.  The  choice  of  climate  must 
be  made,  not  on  the  usual  happy-go-lucky  methods,  nor  from  the 
results  in  a  single  case,  but  by  studying  the  general  principles  of 
climatology  and  then  obtaining  reliable  information  concerning 
the  particular  resort  that  is  likely  to  be  suitable.  Climatology  (in 
which  the  profession  as  a  whole  is  little  learned)  is  not  the  pure 
empiricism  that  many  think,  but  is  a  science  founded  on  natural 
laws  and  strengthened  by  rational  experience. 


10 


CHAPTER   IX. 

FOEMS  OF  DISEASE   OTHEE  THAX  PHTHISIS  AS 
INFLUENCED   BY   CLIMATE. 

Tubercular  Laryngitis. 

The  ouly  reports  which  I  could  find  of  the  influence  of  climate 
upon  tubercular  laryngitis  are  those  of  Dr.  Robert  Levy,  of  Den- 
ver, and  my  own,  which  deal  with  the  effect  of  the  Colorado  climate 
upon  this  disease.  Various  opinions  have  been  expressed  on  the 
subject,  and  most  of  them  advocate  a  mild,  equable  climate  and 
especially  condemn  liigh  altitudes.  Dr.  Clinton  AVagner,  however, 
after  some  experience  in  Colorado  Springs,  wrote  as  follows:  '^  I 
think  that  cases  of  laryngeal  phthisis  may  safely  be  permitted  to 
remain  at  high  altitude  resorts,  provided  improvement  in  the  pul- 
monary trouble  and  general  conditions  has  already  taken  place."  ^ 

Dr.  Lev}",  from  an  extensive  experience  of  several  years  as  a 
laryngologist  in  Denver,  reports  upon  seventy-two  cases  of  tuber- 
cular laryngitis;  thirty  cases  were  reported  to  the  Colorado  State 
^ledical  Society^  and  forty-two  cases  to  the  Pueblo  County  Medical 
Society,  May,  1895.^  Both  reports  are  extremely  interesting  and 
valuable.  They  did  not  admit  of  tabulation  with  my  own,  but  the 
results  show  a  close  resemblance.  His  conclusions  as  here  quoted 
are  also  very  similar.  While  agreeing  with  Heryng  that  climatic 
change  cannot  supplant  local  treatment,  and  advocating  surgical 
procedure  when  possible  and  suitable,  he  says:  "  Still,  judging 
from  these  seventy- two  cases  and  many  others  treated  in  hospital 
and  dispensary  of  which  records  have  not  been  kept,  I  cannot  but 
believe  that  under  proper  treatment  laryngeal  improvement  will  go 
pan  passu  with  that  of  the  lungs." 

Peeling  that  the  relative  effect  of  the  treatment  of  tubercular 
laryngitis  could  only  be  estimated  when  the  quality  of  the  cases  and 
their  relation  to  lung-tuberculosis,  which  almost  invariably  accom- 
panies this  sort  of  laryngeal  disorder,  are  taken  into  consideration,  I 

1  Transactions  of  the  Xew  York  Academy  of  Medicine,  October  20, 18S7. 

-  Transactions,  1891.  s  j^ew  York  Medical  Journal,  July  20, 1895. 


OTHER  FORMS  OF  DISEASE  INFLUENCED  BY  CLIMATE.     147 

reported  before  the  Pan-American  Congress,  1893/  upon  tbe  cases  of 
laryngeal  tuberculosis  occurring  among  250  cases  of  phthisis  treated 
by  me  in  Colorado.  Of  these,  45  exhibited  unmistakable  tubercular 
laryngitis.  25  of  the  laryngeal  cases  showed  clear  signs  of  tuber- 
cular infiltration,  which  had  not,  however,  proceeded  to  the  stage 
of  ulceration  at  the  time  of  the  first  examination,  though  some  of 
them  did  subsequently,  Avhile  20  cases  had  ulceration  as  well  as 
infiltration  when  first  seen. 

Averag-e  Duration.  The  average  duration  of  the  non-ulcerated 
cases,  from  the  date  of  their  first  symptoms  up  to  the  present  time 
or  until  death,  was  six  years;  while  of  17  of  these  cases  which  im- 
proved and  are  living  the  average  duration  is  thirteen  years,  and  of 
the  8  which  are  worse  or  have  died  it  was  but  three  years  and  ten 
months. 

The  total  average  duration  of  the  20  cases  with  ulceration  was 
three  years  and  two  months.  Of  5  cases  which  improved  and  are 
living  the  average  duration  was  eight  years  and  five  months;  wliile 
of  the  fatal  and  deteriorated  cases  it  was  two  years.  Of  the  dete- 
riorated cases,  with  and  without  ulceration,  the  average  duration  was 
two  years  and  seven  months.  This  is  somewhat  longer  than  the 
two-years'  limit  given  by  Bosworth. 

Non-laryngeal.  78  cured,  38  greatly  improved,  30  improved, 
59  worse. 

Laryngeal.  Xon-ulcerated :  6  cured,  7  greatly  improved,  4  im- 
proved, 3  worse,  5  died. 

Ulcerated:  2  cured,  2  greatly  improved,  1  improved,  15  died. 

Total  laryngeal:  8  cured,  9  greatly  improved,  5  improved,  3 
worse,  20  died. 

Grouping  together  the  cured,  the  greatly  improved,  and  the  im- 
proved, under  the  head  of  "improved,"  we  find  that  of  the  205  non- 
laryngeal  cases  72  per  cent,  improved;  but  of  the  45  laryngeal  cases 
only  49  per  cent,  improved.  The  non-ulcerated  cases,  however, 
showed  68  per  cent,  and  the  ulcerated  only  25  per  cent,  of  improve- 
ment. 

Taking  the  condition  of  the  throat,  without  regard  to  the  ultimate 
fate  of  the  patient,  the  results  were  much  better,  there  being  local 
permanent  arrest  of  the  disease  in  64  per  cent.,  beside  5  cases 
which  healed  temporarily.     Among  the  non-ulcerated  alone  68  per 

1  .Therapeutic  Gazette,  November  15, 1893.  • 


148  MEDICAL  CLIMATOLOGY. 

cent,  showed  a  return  to  a  normal  appearance  in  the  larynx,  while 
among  the  ulcerated  cases  50  per  cent,  healed  permanently  and  3 
additional  cases  temporarily. 

With  regard  to  the  position  of  the  ulceration,  the  results  were : 
commissure,  33.3  per  cent,  improved;  true  chords,  30  per  cent.; 
epiglottis,  17  per  cent.;  while  of  the  arytenoids  and  false  chords 
none  improved. 

To  recapitulate,  it  may  be  said  that  of  the  whole  number  of  cases, 
viz.,  250,  rather  more  than  two  out  of  three  improved. 

Of  the  45  which  had  laryngeal  disease,  one  out  of  two  improved. 

Of  the  25  cases  in  which  there  was  laryngeal  tubercular  in- 
filtration without  ulceration,  rather  more  than  two  out  of  three 
improved;  while  of  the  twenty  in  whom  there  was  laryngeal  tuber- 
cular ulceration,  only  one  in  four  improved;  but  of  the  205  cases 
without  laryngeal  disease  there  was  improvement  in  nearly  three 
out  of  every  four  cases,  the  exact  reverse  of  the  laryngeal  ulcerated 
cases. 

This  shows,  as  was  to  be  expected,  that  the  laryngeal  complication 
reduces  the  chance  of  improvement,  and,  when  it  has  proceeded  to  the 
stage  of  ulceration,  does  so  to  the  extent  of  three  to  one.  But  even 
so,  according  to  the  opinions  expressed  by  laryngologists  practising 
in  low  altitudes,  these  are  far  better  results  than  have  usually  been 
obtained,  and  show,  I  believe,  that  similar  effects,  beneficial,  retard- 
ing, and  often  curative,  which  have  been  demonstrated  in  pulmo- 
nary tuberculosis  treated  in  Colorado  and  other  high  altitudes,  are 
exhibited  in  laryngeal  tuberculosis. 

It  is,  of  course,  to  be  expected  that  the  results  are  not  actually  so 
good  as  in  cases  of  simple  pulmonary  tuberculosis,  though  relatively 
they  are  so,  because  in  all  these  cases — and  I  have  never  seen  a  laryn- 
geal tuberculosis  without  an  accompanying  pulmonary  tuberculosis 
— there  was  the  double  disease  and  therefore  the  double  burden  to 
bear. 

Moreover,  it  is  hardly  to  be  doubted  that  these  laryngeal  compli- 
cations almost  always  indicate  a  tendency  to  a  free  dissemination  of 
tubercle  and  generally  an  absence  of  any  self-limiting  features. 
There  are  undoubtedly  some  cases  in  which  the  laryngeal  tubercu- 
losis is  derived  from  an  inoculation  caused  by  the  lodging  of  the 
sputum  upon  the  abraded  laryngeal  membrane;  but  clinical  obser- 
vation leads  me  to  believe  that  in  the  great  majority  of  cases  the 
infection  starts  from  within  and  not  from  without. 


OTHER  FORMS  OF  DISEASE  INFLUENCED  BY  CLIMATE.     149 

Taking  the  results  upon  the  laryngeal  disease  alone,  irrespective 
of  the  ultimate  recovery  or  deterioration  of  the  patient  on  account 
of  the  accompanying  lung-disease,  we  find  that  in  64.2  per  cent, 
there  was  arrest;  and  if  we  consider  also  the  five  in  whom  there 
was  temporary  healing,  which  broke  down  again  under  the  strain 
of  the  last  weeks  of  fatal  pulmonary  suppuration,  we  see  that  the 
percentage  of  improvement  in  the  local  laryngeal  symptoms  is  not 
very  far  short  of  that  in  the  simple  pulmonary  cases. 

While  I  believe  that,  generally  speaking,  high  altitudes  are  really 
beneficial  to  tubercular  laryngitis  (contrary  to  an  impression  once 
commonly  received  that,  as  regards  that  disease,  they  were  positively 
injurious),  it  is  nevertheless  true  that  no  such  results  as  I  report 
could  be  reached,  in  the  majority  of  cases,  without  careful  local 
treatment.  This  remark  especially  applies  to  those  cases  which 
show  ulceration.  As  Bosworth  truly  writes,  after  advocating 
topical  measures,  'Mn  no  ulcerative  process,  probably,  are  we 
able  to  detect  in  a  less  degree  any  reparatory  effort  on  the  part 
of  nature  than  in  tubercular  ulceration,  and  yet  instances  of  spon- 
taneous cicatrization  have  been  reported  by  Bouveret,  Virchow, 
Jar  vis,  and  others." 

In  conclusion,  it  may  be  said  that  the  foregoing  facts  indicate 
that  while  tubercular  laryngitis  is  always  a  grave  complication,  at 
an  altitude  as  elsewhere,  and  that  when  advanced  it  is  almost  inva- 
riably fatal,  yet  in  the  earlier  and  medium  cases  high  altitudes,  with 
appropriate  treatment,  afford  relatively,  though  not  actually,  as 
good  a  chance  for  arrest  or  delay  in  laryngeal  as  in  pulmonary 
tuberculosis.  With  respect  to  the  influence  of  low  altitudes,  I  be- 
lieve that  where  most  relief  is  afforded  to  the  accompanying  pul- 
monary tuberculosis  the  lesions  are  most  likely  to  heal  under  appro- 
priate treatment. 

Tuberculoses  other  than  those  of  the   Respiratory  Tract. 

My  experience  leads  me  to  believe  that  the  question  of  climatic 
change  for  all  other  forms  of  tuberculous  disease  must  be  answered 
upon  the  same  grounds  as  that  of  change  for  pulmonary  tuberculosis. 
There  are,  however,  certain  modifications  to  this  statement  which 
will  be  discussed  under  the  head  of  Scrofulosis. 

Scrofulosis  is  a  diathesis  which  renders  its  victims  peculiarly 
liable  to   tuberculosis  and   induces  chronicity  of  inflammatory  pro- 


150  MEDICAL  CLIMATOLOGY. 

cesses  and  ioflaramation  of  the  adjacent  glands.  It  tends  to  produce 
hyperplasia  and  caseation  of  the  lymphatic  glands.  The  object  in 
the  treatment  of  a  scrofulous  person,  whether  child  or  adult,  is  to 
increase  the  vital  resistance,  especially  to  bacillary  invasion  and  con- 
sequent tuberculosis.  The  open  lymph-spaces  and  feeble  vitality 
allow  the  bacilli  to  spread  readily  through  the  body,  and  where 
hyperplasia  or  caseation  has  occurred  a  peculiarly  congenial  soil  is 
presented  for  the  development  of  tuberculosis. 

Some  years  ago,  during  my  visits  to  the  Infirmary  for  Scrofula, 
at  Margate,  England,  a  resort  possessing  a  beach  with  a  good  sand 
and  gravel  soil  and  endowed  with  a  mild,  sunny  climate,  I  was 
much  struck  by  the  remarkable  improvement  in  scrofulous  children, 
particularly  in  those  cases  where  the  disease  had  attacked  the  bones. 
Later  experience  has  confirmed  me  in  the  opinion  that  a  warm 
seaside-resort,  where  much  outdoor  life  and  sea-bathing  can  be  ob- 
tained, is  the  best  for  counteracting  the  scrofulous  habit  and  early 
tuberculosis;  but  when  the  tuberculosis  is  advancing  an  elevated 
climate  is  generally  more  beneficial. 

Sea-bathing.  With  regard  to  its  benefits  for  the  scrofulous.  Dr. 
D'Espine'  writes  that  of  308  children,  from  four  and  one-half  to 
fifteen  years  old,  who  were  sent  to  the  Mediterranean  coast  of  France 
because  of  various  scrofulous  affections,  48  cases  were  cured,  215 
improved,  44  were  unimproved,  and  1  died.  They  each  had  about 
forty-five  sea-baths  during  a  stay  of  six  weeks.  Jacobi  and  Casse 
and  many  French  authorities  are  favorable  to  sea-bathing.  Treves 
thinks  the  effects  are  chiefly  mental.  Dr.  Walter  Chrystie^  writes 
as  follows  :  "  The  writer  is  convinced  that  salt-baths  stimulate 
nutrition,  and  is  in  the  habit  of  directing  scrofulous  persons  to  add 
a  small  amount  of  sea-salt  to  the  batl)  once  or  twice  a  week." 

Sea-  and  Mountain-air.  With  reference  to  climate.  Dr.  Chrystie 
goes  on  to  say  :  "  The  efficacy  of  sea-air  in  eradicating  the  scrofu- 
lous diathesis  and  its  manifestations  is  admitted  by  all  writers,  and 
is  especially  dwelt  upon  by  Deligny,  who  made  a  large  number  of 
observations  upon  scrofulous  children  treated  in  L'Hopital  de  Berck 
on  the  coast  of  France.  Frederick  Treves  also  writes  that  the 
records  of  the  INIargate  Infirmary  for  Scrofula  support  the  fact 
that  sea-air  possesses  a  curative  influence  upon  scrofula  by  show- 
ing a  large  number  of  cures  and  a  still   larger  number  of  cases  of 

1  Revue  med.  de  la  Suisse  Romande,  September,  188S. 
-  Hall's  System  of  Therapeutics,  vol.  i.  p.  930. 


OTHER  FORMS  OF  DISEASE  INFLUENCED  BY  CLIMATE.     ]51 

marked  improvemeDt.  But  he  adds  that  '  the  greatest  advantage  is 
observed  in  instances  of  acquired  struma,  in  cases  where  the  disease 
has  developed  in  the  purlieus  of  a  great  town,  and  in  those  patients, 
in  fact,  to  whom  sea-breezes  and  outdoor  exercises  offer  the  most 
striking  possible  contrast  to  their  previous  surroundings.'  "' 

Cases  will  occasionally  be  met  with  which  do  not  improve  in  a 
coast  climate  or  which  improv^e  exceedingly  slowly,  notwithstanding 
the  utmost  care  in  the  selection  of  diet.  Such  cases  will  often  im- 
prove rapidly  if  removed  to  a  dry,  moderately  elevated,  mountainous 
region. 

It  is  extremely  difficult  and  often  impossible  to  determine  which 
climate  will  be  the  most  beneficial  in  a  given  case.  Treves  thinks 
that  the  cases  which  do  not  improve  at  the  seaside  are  usually  those 
with  a  ''  phthisical  tendency,"  also  many  cases  of  eczema,  some  cases 
of  strumous  ophthalmia,  and  a  ^q\n  cases  of  lupus.  The  author's 
experience  has  been  that  cases  in  which  there  is  marked  anaemia, 
muscular  debility,  or  exhaustion  from  the  presence  of  complications, 
such  as  glandular  suppuration,  bone-disease,  etc. — in  other  words, 
cases  with  well-marked  tubercular  disease,  excluding  pulmonary 
phthisis — usually  improve  more  rapidly  in  sea-air,  and  that  cases 
with  the  scrofulous  diathesis  alone  are  better  in  mountain-air. 

Many  cases  gain  in  weight  and  appearance  in  a  coast  climate 
for  a  few  months,  and  then  come  to  a  standstill  or  even  retrograde. 
Under  such  circumstances  a  removal  inland  is  usually  followed  by 
renewed  improvement.  Indeed,  in  some  cases  frequent  change  of 
climatic  surroundings  is  necessary  in  order  that  the  improvement 
may  be  continuous,  and,  in  all  cases,  a  week  or  two  at  the  seashore 
can  do  no  harm  if  it  be  preparatory  to  a  more  prolonged  sojourn  in 
a  mountain  climate. 

Affections  of  the  Respiratory  Tract  other  than  Phthisis. 

Croupous  Pneumonia.  In  this  affection  the  use  of  climate  has 
only  to  be  considered  during  the  stage  of  convalescence.  Resolu- 
tion of  the  pneumonia  and  a  return  to  health  are  frequently  assured, 
and  generally  hastened  by  change  of  air. 

The  climates  most  convenient  to  the  place  in  which  the  sickness 
has  occurred  and  which  afford  the  most  opportunities  for  the  invalid 
to  rest  in  the  open  air  without  danger  of  catching  cold,  are  usually 
the  best.  A  warm  seashore,  or  a  dry,  sunny,  inland  spot  with  a 
sandy  soil,  is  generally  the  most  suitable  choice  for  the  early  days 


152  MEDICAL  CLIMATOLOGY. 

of  convalescence,  and  when  strength  has  been  sufficiently  regained 
to  allow  of  taking  exercise  it  is  wise  to  seek  the  more  bracing  air  of 
the  uplands  to  complete  the  cure.  When,  in  spite  of  these  mod- 
erate changes,  resolution  is  delayed  or  tuberculosis  supervenes,  the 
high  altitudes  should  be  resorted  to,  as  there  the  anseraia,  which  is  the 
most  common  cause  of  delay  in  recovery,  is  most  quickly  and  surely 
combated. '^  On  the  other  hand,  if  the  disease  has  occurred  on  high 
ground,  a  change  to  a  lower  climate  is  indicated. 

In  deciding  the  question  of  sending  a  patient  with  an  unresolved 
pneumonia  to  elevated  ground  the  condition  of  the  heart  and 
breathing  should  be  carefully  considered,  the  heart  being  examined 
not  only  during  rest,  but  after  exercise,  and  especially  after  climbing 
stairs.  A  moderate  degree  of  weakness  can  be  taken  care  of  in 
those  under  thirty-five  years  of  age,  proper  precautions  concerning 
exercise  being  taken.  For  those  who  are  older  it  is  wisest  to  select 
elevations  under  3000  feet  until  experience  shows  that  the  patient 
may  safely  be  advanced  to  higher  ground.  In  all  cases  the  amount 
of  unused  lung  of  course  enters  into  the  problem,  obstruction  in  the 
left  lung  being  more  detrimental  than  the  same  amount  in  the  right. 
If  the  lungs  are  seriously  involved  or  the  heart  manifestly  weak,  it 
is  always  best  for  the  patient  to  go  to  bed  immediately  on  arriving 
and  to  send  for  his  physician  before  taking  any  exercise.  The 
late  Dr.  A.  L.  Loomis  dwelt  upon  the  injurious  effects  to  the 
heart  in  certain  cases  sent  to  the  Adiroudacks  at  an  elevation  of 
1600  feet,  and  in  Colorado  Springs  (6000  feet)  I  have  seen  such 
serious  injury  result  to  patients  whose  hearts  had  been  considered 
normal,  from  their  walking,  on  first  arrival,  a  few  hundred  yards 
up  a  slight  incline  from  the  station,  as  to  make  it  necessary  to  send 
them  back  in  a  short  time  to  sea-level.  However,  when  the  cases 
are  wisely  selected  and  properly  warned  as  to  exertion  there  is  little 
risk,  and  the  results,  in  cases  of  retarded  pneumonia,  whether  simple 
or  tuberculous,  are  generally  much  more  brilliant  in  high  altitudes 
than  elsewhere. 

Catarrhal  Pneumonia.  Convalescents  from  this  affection  are 
often  given-  moderate  change  of  air  with  benefit  at  an  earlier  stage 
than   the  croupous  cases.      In  these,  as  a  rule,  warmer  and   more 

1  In  selecting  a  high  climate,  it  must  be  remembered  that  the  drier  atmosphere  is  generally 
the  better,  and,  if  the  invalid  has  progressed  to  the  point  of  taking  exercise,  and  evinces  fair 
powers  of  reaction,  the  climate  chosen  should  also  be  moderately  cool  on  account  of  the  greater 
tonic  effect. 


OTHER  FORMS  OF  DISEASE  INFLUENCED  BY  CLIMATE.     153 

equable  climates  of  moderate  elevation  are  best.  Those  cases  in 
which  the  tendency  to  fever  and  irritability  of  the  membranes  is 
slight  are  better  suited  to  higher  and  drier  ground,  even  though 
the  climate  is  neither  so  warm  nor  so  equable  as  that  lower  down  ; 
while  for  those  with  the  contrary  tendencies  the  sea  or  a  slight 
elevation,  such  as  is  to  be  found  on  an  upland  or  hillside,  or  a 
moorland,  is  better  than  such  an  altitude  as  that  of  a  mountain  or 
high  plateau.  When  the  patient  is  also  tuberculous  higher  ground 
can  more  often  be  sought  with  benefit  than  in  cases  of  simple  ca- 
tarrhal pneumonia,  the  other  considerations  referred  to  being  allowed 
due  weight. 

Pleurisy,  When  the  convalescent  stage  is  reached,  the  fluid 
having  been  absorbed  or  removed  by  tapping,  it  sometimes  happens 
that  recovery  is  unduly  delayed  owing  to  anaemia  or  to  a  bound- 
down  lung,  or  both,  and  that  a  moderate  change  of  air  is  not  suffi- 
cient to  complete  the  cure.  In  such  cases  a  visit  to  the  higher 
altitudes  is  nearly  always  the  most  effective  and  speedy  remedy; 
but  here,  again,  the  condition  of  the  heart,  especially  if  that  organ 
is  displaced,  must  be  as  carefully  considered  as  in  a  case  of  pneu- 
monia. If  the  patient  goes  to  an  altitude,  the  direction  of  his  exer- 
cise must  at  once  be  intrusted  to  a  physician. 

Empyema.  Cases  of  delayed  recovery  do  remarkably  well  on 
high  ground,  as  they  do  also  on  a  warm,  sheltered  seashore.  The 
climate  to  which  the  patient  is  sent  should  be,  as  far  as  is  possible, 
a  contrast  to  the  one  in  which  the  disease  arose;  and  each  case, 
whether  tuberculous  or  simple,  must  be  decided  with  a  proper  con- 
sideration of  the  same  principles  referred  to  as  being  applicable  to 
pneumonia. 

Bronchitis,  unless  tuberculous — and  a  majority  of  the  cases  of 
chronic  bronchitis  become  so — is  usually  soonest  cured  in  a  dry, 
warm,  inland  climate  of  very  moderate  elevation  where  there  is  little 
wind. 

Asthma, 

which  is  generally  either  bronchial  or  nasal  (hay-fever),  and  at 
times  both,  may  be  defined  as  a  spasm  of  the  bronchial  tubes, 
which  has  a  predisposing,  a  determining,  and  an  exciting  cause. 
The  predisposing  cause  is  a  peculiar  neurotic  habit.  The  determin- 
ing cause  is  some  disorder  or  disease  of  the  respiratory  tract  which 
can  generally  be  classed  as  bronchial  or  nasal.     The  exciting  causes 


154  MEDICAL  CLIMATOLOGY. 

are  very  iiamerous,  and  are  either  intrinsic  or  extrinsic.  The  in- 
trinsic cause  may  be  an  ordinary  catarrh  or  inflammation  of  some 
portion  of  the  respiratory  tract,  or  indeed  of  any  other  portion  of 
the  body,  or  organic  disease,  such  as  that  of  the  heart,  indepen- 
dently of  true  cardiac  dyspnoea;  or  it  may  be  simply  a  derangement 
of  function,  as  in  dyspepsia,  or  a  nerve-storm,  or  other  disturbance, 
physical  or  mental.  The  extrinsic  causes  are  also  various,  being 
generally,  for  bronchial  asthma,  changes  in  atmospheric  conditions, 
and,  for  nasal,  the  inhalation  of  the  pollen  of  a  particular  plant,  or 
of  dust,  or  of  some  animal  exhalation. 

Bronchial  Asthma.  In  selecting  a  climate  for  an  asthmatic  it  must 
be  determined  which  of  the  causes  it  is  most  important  to  remove,  as 
one  climate  excels  another  in  its  influence  over  one  or  more  of  these 
causes.  It  is  impossible,  in  actual  practice,  to  separate  these  causes 
and  to  treat  each  in  its  appropriate  climate;  but  it  will  perhaps  be 
well  to  try  to  explain  why  so  many  different  climates  and  conditions 
are  good  for  asthmatics,  and  to  assist  in  making  the  best  possible 
compromise  when  a  climate  is  finally  chosen,  thus  causing  the 
selection  to  be  less  empirical  and  experimental  than  it  usually  is. 
\Ye  must  presume,  in  the  first  place,  that  the  physician  or  surgeon 
has  done  all  that  lies  in  his  power  to  remove  or  modify  one  or  more 
of  the  three  causes.  Let  us  suppose  that  the  neurosis  is  the  cause 
to  be  especially  remedied;  the  climate  must  then  be  chosen  for  its 
quality  of  sedation  or  stimulation.  If  the  hypersesthesia  is  appar- 
ently innate  in  the  individual  and  customary  to  him,  and  is  not 
brought  about,  or  largely  aggravated,  by  anaemia  or  some  other 
depressing  cause,  a  sedative  climate  is  generally  most  beneficial, 
because  it  modifies  the  neurotic  habit.  Further,  as  the  catarrh  or 
chronic  inflammation  of  the  respiratory  tract  is,  in  what  is  termed 
a  born  neurotic,  usually  of  the  irritable  or  inflammatory  type,  a 
climate  of  a  sedative  character,  in  which  the  air  is  warm,  humid, 
and  equable,  would  be  the  most  beneficial ;  but  the  climate  selected 
should  also  possess  tonic  qualities  in  proportion  as  the  respiratory 
condition  permits  a  lessening  of  this  warmth  and  humidity  and 
consequently  of  climatic  equability.  If  there  is  chronic  anaemia,  a 
stimulating  climate,  cooler,  drier,  and  more  variable,  would  be  pre- 
ferable. 

The  one  meteorological  element,  however,  which  has  the  most 
marked  effect  upon  the  neurosis  of  asthma  is  barometric  pressure, 
either  markedlv  increased  or  decidedlv  decreased.     Both  conditions 


OTHER  FORMS  OF  DISEASE  INFLUENCED  BY  CLIMATE.     155 

are  of  the  greatest  benefit,  as  is  shown  by  laboratory  experiments 
and  also  by  the  actual  experience  of  asthmatics  in  depressed  parts 
of  the  earth's  surface,  such  ai?  the  valley  of  the  Dead  Sea  and  the 
sink  of  California;  and  at  great  elevations,  such  as  the  high 
plateaus  of  the  Alps,  the  Rockies,  and  the  Andes.  With  regard 
to  the  use  of  increased  barometric  pressure,  while  its  effects  at 
the  time  are  striking,  they  are  seldom  lasting,  because,  if  it  be  used 
in  the  laboratory,  its  application  is  necessarily  intermittent,  and  a 
residence  in  depressed  climates  is  almost  unendurable  from  heat 
during  the  summer  and  is  monotonous  and  depressing  at  all  times. 
On  the  other  hand,  life  at  an  altitude  is  pleasant  and  can  be  continued 
without  interruption.  It  is  possible  to  vary  the  locality,  and  in 
many  places  the  pursuit  of  business  or  amusement  may  be  carried 
on  profitably  and  agreeably.  The  height,  latitude,  and  exposure  of 
the  elevated  region  can  be  selected  in  accordance  with  the  tempera- 
ture, humidity,  aud  variability  best  suited  to  the  particular  con- 
dition of  the  respiratory  tract,  and  a  locality  which  is  free  from  the 
pollen,  dust,  or  animal  exhalation  peculiarly  obnoxious  to  the  in- 
dividual asthmatic  may  be  more  readily  found.  I  believe  it  may 
be  said  that,  other  things  being  equal,  an  altitude  is  best  for  the 
cure  of  the  neurosis ;  but  if,  for  special  reasons,  the  diminished  baro- 
metric pressure  is  unsuitable,  the  next  best  climate  for  the  neurotic 
habit  is  in  a  sink. 

In  deciding  upon  a  climate  with  a  special  view  to  the  cure  of  the 
determining  cause — that  is,  the  disorder  of  the  respiratory  tract — 
the  choice  must  be  made  according  to  the  principles  dwelt  upon 
in  discussing  pneumonia,  bronchitis,  etc.,  and  a  sedative  or  stimu- 
lating climate  selected  accordingly.  If,  however,  the  exciting 
cause  appears  to  be  the  most  important,  that  must  be  especially 
considered.  For  instance,  in  a  cardiac  case  the  deviation  of  the 
resort  is  the  prime  factor ;  but  in  the  case  of  a  dyspejitic  the 
ability  to  obtain  appropriate  food  is  an  absolute  essential.  If,  again, 
the  exciting  cause  be  pollen,  dust,  or  animal  exhalations,  pure  air 
must  be  sought,  and  this  will  be  found,  first,  on  the  ocean,  and  next 
on  the  mountain-side  or  desert-plain. 

Cases  of  chronic  bronchitis  without  marked  emphysema  and  with 
a  heart  in  which  permanent  dilatation  or  other  lesion  is  not  appar- 
ent, are  usually  most  benefited  by  a  change  to  high  ground.  Before 
sending  to  a  high  altitude  any  cases  in  which  the  condition  of  the 
heart  is  questionable,  it  is  well  to  try  the  effect  of  a  moderate  eleva- 


156  MEDICAL  CLIMATOLOGY. 

tion,  such  as  is  found  between  1000  and   2500  feet,  where  the  air 
and  soil  are  fairly  dry  and  the  skies  sunny. 

A.S  is  well  known,  an  adult  asthmatic  is  rarely  permanently 
cured ;  but,  to  modify  Sydney  Smith's  remark  about  a  Scotchman, 
'^  Much  can  be  done  with  an  asthmatic  if  he  is  caught  young."  It 
is  in  youthful  asthmatics  that  I  have  seen  nearly  all  of  the  compara- 
tively few  permanent  cures,  and  among  these  the  use  of  high  alti- 
tudes had  been  the  most  successful  element.  This  is  probably  due 
to  the  breaking  up  of  the  neurotic  habit  and  to  the  cure  of  the  anaemia 
generally  present  in  young  asthmatics. 

Dr.  Denison,  of  Denver,  reported^  52  cases  of  asthma  treated  in 
Colorado,  of  which  72.5  per  cent,  were  more  or  less  improved.  Of 
those  that  got  worse  or  remained  stationary  all  but  one  had  em- 
physema. This  agrees  with  the  experience  of  my  colleagues  and 
myself. 

Hay-fever  [Nasal  Asthma).  With  respect  to  this  form  of  asthma, 
I  may  say,  without  entering  into  a  full  discussion  of  its  causes,  that 
my  observations  in  Colorado  have  convinced  me  that  vegetation,  in 
some  form  or  other,  is  the  most  frequent  exciting  cause,  although 
we  know  that  in  a  few  cases  certain  animal  exhalations  and  inorganic 
dusts  play  the  most  important  part.  The  particular  kind  of  vege- 
table growth,  the  pollen  or  dust  of  which  excites  an  attack  of  hay- 
fever,  is  different  for  different  individuals.  While  it  is  probably  true 
that  a  larger  number  of  cases  of  hay-fever  are  benefited  by  a  change 
to  a  high  altitude,  such  as  the  Alps  or  Colorado,  than  to  lower 
climates,  yet  many  cases  at  altitudes  have  to  shift  their  ground  at 
certain  flowering- seasons,  and  the  relief  thus  afforded  is  probably 
due  to  the  amelioration  of  the  neurosis  by  diminished  pressure,  to 
the  general  purity  of  the  air,  and  to  the  comparative  sparseness  of 
vegetation. 

Geographical  Distribution.  The  following  remarks  concerning 
the  geographical  distribution  of  hay-asthma  are  well  worthy  of 
attention  : 

"One  thing  that  markedly  distinguishes  hay-fever  from  other 
catarrhal  maladies  of  similar  nature  is  its  geographical  relations. 
It  does  not  exist  over  the  whole  of  the  United  States  or  of  Great 
Britain,  yet  it  would  be  a  difficult  task  to  define  its  exact  limits. 
Numerous  portions  of  England  are  immuue,  especially  the  high- 
land  and  seacoast,  and  all  or   nearly   all  of  Wales  and  Scotland. 

1  Transactions  of  the  American  Climatoloffical  Association,  1S90. 


OTHER  FORMS  OF  DISEASE  INFLUENCED  BY  CLIMATE.     157 

In  America  it  obtains  to  the  north  of  Lake  Ontario  in  a  limited 
degree,  but  not  on  the  upper  side  of  the  St.  Lawrence;  scarcely  at 
all  in  the  province  of  Ontario  nortli  of  the  Welland  Canal  until  the 
Detroit  River  is  reached,  and  it  is  wholly  unknown  to  regions  above 
the  outlet  of  Lake  Huron.  In  Michigan,  however,  it  follows  Lake 
Huron  to  above  Saginaw  Bay,  finding  victims  even  at  Alpena, 
though  residents  of  Buffalo,  Cleveland,  Detroit,  and  Cincinnati  are 
here  usually  immune.  On  Lake  Michigan  its  effects  are  lost  above 
Ludington,  while  over  the  Mississippi,  in  Wisconsin,  it  is  felt  as 
far  north  as  the  junction  of  the  Chippewa,  and  in  some  seasons 
extends  in  a  mild  form  to  St.  Paul,  Minn.  To  the  south  it  extends 
to  the  latitude  of  Memphis  in  the  west,  Knoxville  in  the  central 
area,  and  Cape  Henry  on  the  Atlantic.  In  all  this  area  there  are 
immune  districts  at  high  altitudes,  such  as  the  Green,  White, 
Adirondack,  Allegheny,  and  Catskill  Mountains,  and  the  southern 
Xew  York  region.  Isolated  spots  where  the  malady  prevails  are 
found  about  Galveston,  Texas;  St.  Augustine,  Florida;  Mont- 
gomery, Alabama;  and  Milledgeville,  Georgia.  Beyond  the  Mis- 
sissippi evidence  and  data  are  almost  wholly  lacking;  but  several 
persons  have  suffered  at  Denver,  Colorado  Springs,  and  Golden 
City,  though  denizens  of  cis~Mississippi  regions  here  find  relief."^ 
AVhere  the  attacks  are  chiefly  dependent  on  vegetation  the  surest 
remedy^  is  naturally  a  sea- voyage;  but  if  the  noxious  plant  be 
known,  the  flora  of  the  proposed  resort  should  be  studied  before 
chano-ing:  a  land  climate.^  Where  the  chronic  catarrhal  condition 
is  prominent  as  a  cause  and  cannot  be  removed  by  treatment,  the 
climate,  with  respect  to  its  humidity  and  temperature,  must  be 
selected  as  the  experience  of  the  individual  or  a  general  infereuce 
dictates. 

Nasal  and  Pharyngeal  Catarrhs. 

The  surgeon,  on  the  one  hand,  and  the  physician,  on  the  other,  have 
so  narrowed  the  field  of  treatment  by  cKmate  of  these  affections  that 
there  is  very  little  to  be  said  specifically.  Change  of  air  is  often  of 
benefit,  especially  as  a  supplement  to  surgical  or  medical  treatment; 
but  its  selection  must  depend  upon  the  general  or  local  condition  of 
the  patient,  one  being  usually  of  greater  importance  than  the  other. 

1  Medical  Age,  Detroit,  1896.  -  Ibid-,  September  10,  1896. 

3  It  has  been  noticed  in  Colorado  Springs  and  Denver  that,  when  the  weeds  are  allowed  to 
grow  freely,  cases  of  hay-fever  are  less  often  reUeved,  and  perhaps  the  greater  amount  of 
watering  done  in  cities  has  an  influence. 


158  31EDICAL   CLIMATOLOGY. 

For  instance,  a  stimulating  air  may  be  best  for  the  general  health, 
while  the  mucous  membrane  may  be  more  benefited  by  a  sedative 
climate.  Nasal  and  pharyngeal  catarrhs  are  common  in  all  climates 
where  there  is  much  variability,  whether  they  be  warm  or  cool, 
moist  or  dry,  high  or  low,  and  the  greatest  benefit  is  usually  derived 
from  the  climate  which  is  in  sharpest  contrast  to  that  in  which  the 
catarrh  was  contracted. 

Chronic  Laryngitis. 

When  this  affection  is  not  entirely  amenable  to  suitable  treat- 
ment at  home  it  is  usually  benefited  by  a  change  of  air  opposed  in 
character  to  that  in  which  the  condition  first  arose,  and  the  question 
has  to  be  considered  on  the  same  principles  as  those  referred  to  con- 
cerning nasal  and  pharyngeal  catarrhs.  Tubercular  laryngitis  is 
discussed  in  the  chapter  on  Phthisis. 

Diseases  of  the  Heart  and  Great  Vessels. 

We  can  all  remember  the  time  when  a  patient  who  was  pro- 
nounced to  have  heart-disease  was  warned  to  avoid  all  exercise,  and 
was  hardly  considered  to  be  fulfilling  his  natural  destiny  unless  he 
died  suddenly.  Fortunately,  the  study  and  treatment  of  the  under- 
lying causes  of  heart-lesions  or  irregularities  have  done  much  to 
prolong  the  life  of  patients  and  have  led  to  more  frequent  cures. 

There  are  two  points  of  view  from  which  change  of  climate  for  a 
heart-case  must  chiefly  be  looked  at :  the  first  is  the  general  con- 
dition and  tendencies  of  the  patient;  the  second,  the  mechanical 
condition  of  the  heart  or  pump.  In  the  heart  the  strength  and 
resiliency  of  the  cardiac  muscle  are  of  the  greatest  importance,  and 
the  quality  of  the  climate  and  the  amount  of  exercise  allowed 
should  be  determined  by  these  conditions  rather  than  by  the  nature 
of  the  valvular  lesion.  The  diagnosis  can  often  be  aided  by  experi- 
menting cautiously  with  different  exercises  before  leaving  home. 

Cardiac  cases  are  often  slightly  affected  by  a  moderate  change 
of  air  even  when  this  is  unaccompanied  by  an  increase  in  elevation, 
and  they  are  generally  very  much  affected  when  climatic  change  and 
increase  in  altitude  are  united.  It  is  therefore  of  the  utmost  im- 
portance that,  after  the  resort  has  been  selected  with  due  care  and 
the  journey  properly  planned,  the  patient  should  be  advised,  from 
the  first  hour  of  his  arrival,  by  a  local  physician  especially  as  to 
his  exercise,  habits,  and  diet. 


OTHER  FORMS  OF  DISEASE  INFLUENCED  BY  CLIMATE.     I59 

When  a  heart-case  is  to  be  sent  to  an  elevated  resort  the  tem- 
perament of  the  patient  enters  into  the  question ;  for,  if  he  be  heed- 
less and  likely  to  neglect  the  advice  of  his  physician,  he  is  certainly 
safer  on  low  ground.  Again,  if  the  patient  be  of  the  erethic  type, 
he  is  apt  to  have  an  irritable  heart,  in  which  case  a  sedative  climate 
is  more  suitable. 

The  age  of  the  patient  has  much  to  do  in  the  selection  of  a  climate. 
In  the  young,  moderate  dilatation,  a  frequent  accompaniment  of 
phthisis,  does  not  prevent  a  patient's  being  sent  to  an  altitude  if  it 
is  otherwise  expedient ;  for,  when  great  care  is  exercised  or  absolute 
rest  prescribed  for  the  first  month,  such  cases  generally  recover  more 
quickly  and  completely  than  at  sea-level.  On  the  other  hand,  when 
the  dilatation  is  well  marked  or  if  the  invalid  is  approaching  middle- 
life,  a  high  altitude  is  dangerous.  Hypertrophy  generally,  though 
not  necessarily,  contraindicates  a  change;  but  this  depends  upon 
its  extent  and  duration  and  the  attendant  circumstances.  Any 
disease  or  irregularity  of  the  heart  or  great  vessels  in  elderly  per- 
sons, particularly  if  there  are  indications  of  atheroma,  should  be 
treated  at  sea-level  and  in  a  sedative,  warm,  equable  climate. 

Cases  of  aneurism  in  the  aged  or  in  prematurely  old  persons 
should  be  treated  in  the  same  way;  but  I  have  observed  in  Colo- 
rado that  most  patients  suffering  from  aneurism  enjoy  a  greater 
sense  of  well-being  and  apparently  improve  more  than  when  living 
at  sea-level.  Several  cases  now  residing;  in  Colorado  have  remained 
in  a  stationary  condition  far  longer  than  I  expected.  The  observa- 
tions of  Weber  and  other  clinicians,  and  particularly  those  of  Arch- 
ibald Smith  in  the  Andes,  agree  with  this  opinion.^ 

In  choosing  a  climate  for  a  case  of  cardiac  or  vascular  disease  it 
has  first  to  be  determined  whether  it  is  reasonable  to  expect  cure 
or  arrest,  or  only  palliation.  In  the  first  case  the  more  tonic  and 
stimulating  climates  may  be  cautiously  tried,  beginning  with  the 
bracing  air  of  a  seashore-resort  and  advancing,  first,  to  a  dry,  desert 
climate  like  Egypt,  then  to  a  slight  altitude,  and  then  to  a  high  one 
through  the  intermediate  climates,  and  choosing  from  these  accord- 
ing to  the  degree  of  stimulation  thought  to  be  safe  or  found  by 
experience  to  be  so. 

On  the  other  hand,  when  the  disease  is  of  such  a  character  as  to 
make  it  unwise  to  attempt  to  level  up  the  patient's  health  and  to 

1  The  physiological  causes  for  this  are  dwelt  upon  on  page  \\A. 


160  MEDICAL  CLIMATOLOGY. 

put  extra  work  upon  the  peccant  organ,  levelling  down  must  ])e 
carried  out  and  the  ship  of  life  made  to  sail  on  an  even  keel. 

Again,  in  choosing  a  climate  for  cardiac  and  vascular  cases,  not 
only  does  the  condition  of  the  kidneys,  skin,  and  lungs  demand  the 
gravest  consideration,  but  also  the  effect  of  the  proposed  change 
upon  them.  If  there  be  one  organ  which,  more  than  another, 
requires  the  most  careful  scrutiny  before  an  invalid  is  sent  from 
home  to  any  positive  climate  whatever,  it  is  the  heart,  and  this  scru- 
tiny must  be  something  more  than  auscultation  while  the  patient  is 
calmly  sitting  in  a  chair.  Some  attempt  must  be  made  to  reproduce 
temporarily  the  climatic  conditions  to  which  it  is  proposed  to  subject 
him.  The  examination  of  the  kidneys  is  next  in  importance  to  that 
of  the  heart,  and  is  a  necessary  adjunct  of  it.  Both  of  these  inquiries 
are  too  frequently  neglected,  or  are  at  most  passed  over  in  a  perfunc- 
tory manner,  often  to  the  injury  of  the  patient  and  the  discomfiture 
of  the  health-resort  physician. 

Again,  in  choosing  a  resort  for  a  heart-case  the  effect  of  the  climate 
upon  the  liver  requires  some  thought,  for  it  is  well  known  that 
through  the  portal  circulation  the  hepatic  functions  influence  the 
cardiac  very  markedly  in  some  cases. 

As  a  change  to  a  high  altitude  is  the  most  extreme  that  can  be 
made  for  these  cases,  I  will  quote  from  the  opinions  expressed  by 
two  of  the  leading  authorities — Dr.  Hermann  Weber,  of  London, 
and  Dr.  Frederick  I.  Ivniglit,  of  Boston. 

Dr.  AVel)er^  writes:  ''  The  diseases  which  are  unfavorably  influ- 
enced include  most  cases  of  organic  disease  of  the  heart  and  vessels, 
though  a  heart  moderately  enlarged,  with  a  weak  muscle,  even  with 
a  bruit,  is  often  improved,  and  generally  much  more  so  than  on  the 
coast.  Even  cases  of  aneurism  are  often  relieved.  Atheroma  and 
senile  affections  generally  contraindicate  a  high  climate." 

Dr.  Knight,  after  prefacing  his  statements  by  saying  that  he  refers 
particularly  to  altitudes  from  about  four  to  six  thousand  feet,  writes 
thus : 

''1.  Cases  of  valvular  disease  with  sufficient  cardiac  enlargement 
or  derangement  of  the  circulation  to  make  the  diagnosis  certain. 
While  a  great  difference  in  risk  in  such  cases  must  be  admitted, 
dependent  upon  the  compensation,  the  age  of  the  patient,  etc. ,  it  is 
safer  to  forbid  the  change  to  such  patients,  for  we  know  that  in 

1  Ziemssen's  Handbook  of  Therapeutics. 


OTHER  FORMS  OF  DISEASE  INFLUENCED  BY  CLIMATE.     161 

any  case,  even  at  sea-level,  compensation,  for  some  unknown  and 
unexpected  reason,  may  suddenly  cease,  and  of  course  this  may  be 
precipitated  by  such  a  change  of  pressure  as  would  be  experienced 
by  a  change  in  altitude  of  five  thousand  feet.  I  say  this,  knowing 
that  Dr.  Solly  and  others  have  had  young  cardiac  patients  with  good 
compensation  who  have  been  not  only  uninjured,  but  invigorated 
and  improved  by  residence  in  Colorado. 

"'  2.  Cases  of  chronic  myocarditis  or  fatty  degeneration.  These 
should  be  rigidly  excluded,  and  these  are  the  cases  about  which 
more  care  should  be  exercised.  They  are  the  cases  among  which  there 
is  such  sudden  fatality,  caused  apparently  by  slight  variations  from  a 
dull  routine  of  life.  A  sudden  change  of  conditions  under  which  the 
heart  is  laboring  stops  it  altogether.  This  change  may  be  one  of  atmos- 
pheric pressure,  a  change  of  nerve-influence,  a  sudden  excitement  of 
joy  or  grief,  a  fall,  a  shock  of  any  kind,  mental  or  physical.  There 
may  or  may  not  have  been  symptoms  calling  attention  to  the  heart,  or 
the  symptoms  may  have  been  wrongly  interpreted — as,  e.g.,  calling  an 
attack  of  angina  pectoris  '  gastralgia.'  Many  cases  have  been  declared 
sound  on  superficial  examination  chiefly  because  no  cardiac  murmur 
was  discovered,  when  a  more  careful  examination  would  have  re- 
sulted in  the  probable  diagnosis  of  one  of  the  above-mentioned  con- 
ditions. A  careful  examination  should  be  made  of  the  area  of  car- 
diac dulness.  It  will  often  be  found  enlarged  in  cases  of  chronic 
myocarditis.  The  character  of  the  first  sound  at  the  apex  should 
be  carefully  studied.  A  very  valvular  first  sound,  an  almost  entire 
loss  of  the  booming  or  muscular  quality,  with  a  weak  and  irregular 
pulse  in  a  man  no  longer  young,  especially  in  connection  with  any 
subjective  symptoms,  points  to  myocarditis  or  fatty  degeneration. 
Breathlessness  on  slight  exertion  and  a  feeble,  irregular  pulse  are 
strong  confirmatory  signs.  It  is  much  more  important  to  keep  this 
kind  of  a  case  out  of  high  altitudes  than  those  of  valvular  disease. 
A  person  over  fifty  years  of  age  with  marked  cardiac  symptoms  or 
any  of  the  signs  mentioned  al)ove  must  not  be  allowed  to  make  the 
change. 

"  3.  Cases  which  present  a  murmur  anywhere  in  the  cardiac  area, 
but  who  have  never  had  any  symptoms,  and  who  on  physical  exami- 
nation show  no  further  evidence  of  disease.  The  murmur  is  fast 
losing  the  undue  importance  which  was  attached  to  it  for  many  years, 
and  is  falling  into  its  proper  place  as. only  one  link  in  a  chain  of  evi- 
dence.    Even  life-insurance  companies  accept  some  applicants  with 

11 


162  MEDICAL  CLIMATOLOGY. 

cardiac  raarmurs.  Patients  with  systolic  murmurs  which  are  known 
to  have  existed  for  many  years  without  any  enlargement  of  the  heart 
or  any  alterations  of  its  normal  sounds  may  be  allowed  to  go  into 
hio;h  altitudes.  Patients  with  murmurs  in  diastole  must  be  advised 
much  more  cautiously,  as  these  murmurs  are  more  surely  indicative 
of  serious  organic  disease. 

^'4.  Cases  of  nervous  palpitation.  Patients  with  functional  pal- 
pitation cannot  be  considered  in  one  class.  In  many  such  palpita- 
tion is  quite  temporary,  due  to  errors  in  diet  or  mode  of  life,  which 
can  be  easily  set  right.  When  these  errors  have  been  corrected,  of 
course  there  can  be  no  objection  to  the  patient's  going  to  a  high  alti- 
tude. Affections  of  this  kind,  due  directly  to  some  morbid  condi- 
tion of  the  nervous  centres,  may  be  divided,  as  by  Eskridge,  into  two 
classes — that  of  patients  who  have  inherent  nervous  temperaments 
and  that  of  those  who  are  nervous  from  malnutrition.  The  latter,  as 
is  pretty  generally  conceded,  are  likely  to  be  improved,  and  conse- 
quently the  trial  of  a  high  altitude  may  be  recommended  to  them ;  but 
the  former,  those  of  inherent  nervous  temperament,  are  usually  made 
worse  by  it,  and  consequently  should  be  forbidden  the  high  altitude." 

I  will  close  this  subject  with  some  remarks  of  my  own.^  The  de- 
cided efFect  of  a  high  altitude  in  exciting  and  disturbing  the  action 
of  the  heart  in  sensitive  persons,  even  without  disease,  is  shown 
by  many  who,  after  living  comfortably  for  several  years  at  Colorado 
Springs  (elevation,  6000  feet),  ascend  to  the  summit  of  Pike's  Peak, 
8000  feet  higher.  These  persons,  while  there,  except  for  a  feeling  of 
light-headedness,  are  all  right  so  long  as  they  do  not  attempt  to  walk, 
but  even  a  few  steps  will  sometimes  bring  on  rapid  and  often  irreg- 
ular beating  of  the  heart,  generally  slight  headache,  often  nausea  and 
diarrhoea,  and  in  some  slight  precordial  pain;  the  headache  and  pain 
over  the  heart  often  persist  more  or  less  for  twenty-four  hours  after 
the  descent  to  lower  ground. 

Nervous  Disorders. 

Organic  disease,  when  progressive,  requires  a  sedative  climate  at 
or  near  sea-level,  with  a  humid  air  and  a  moderate  rainfall,  where 
warmth  and  equability  are  present.  When  the  disease  is  stationary, 
mildly  stimulating  climates  may  be  cautiously  used,  and  in  some 
exceptional  cases  even  the  high  altitudes.     I  have,  for  instance,  seen 

'  Article  upon  Climate  in  Hare's  System  of  Therapeutics. 


OTHER  FORMS  OF  DISEASE  INFLUENCED  BY  CLIMATE.     163 

improvement  in  some  stationary  cases  of  progressive  locomotor 
ataxia,  brought  into  Colorado,  and  also  in  certain  cases  of  other 
chronic  paralyses.  It  is  always  risky  to  send  cases  with  well-marked 
organic  lesions  to  high  ground,  particularly  where  the  patient  is  of 
full  habit  or  inclined  to  inflammatory  or  irritable  nervous  conditions. 
It  is  only  when  the  destructive  processes  are  arrested  that  an  accom- 
panying anaemia  can  sometimes  be  best  treated  at  an  altitude;  as  a 
rule,  however,  such  cases  do  better  during  summer  months  at  eleva- 
tions of  from  1000  to  2500  feet. 

Meningitis  is  especially  unsuited  to  treatment  in  high  climates, 
and  even  a  seacoast  air  is  apt  to  be  too  stimulating. 

I  find  in  medical  literature  very  few  references  to  the  influence  of 
clinaate  upon  nervous  diseases,  and  these  are  of  the  most  general 
character.  Dr.  J.  T.  Eskridge,  of  Denver,  from  the  standpoint  pf  a 
neurologist  enjoying  the  opportunities  of  a  large  practice  of  several 
years  in  Colorado,  wrote  a  valuable  and  conservative  paper^  which 
throws  much  light  upon  the  influence  of  a  high  altitude  in  nervous 
disorders,  and  indirectly  explains  by  inference  the  effects  of  lower 
climates.      I  will  therefore  give  the  gist  of  some  of  his  remarks: 

According  to  Eskridge,  numerous  careful  observations  which  he 
has  taken  of  the  temperature  of  the  surface  of  the  body,  and  espe- 
cially of  the  head,  show  that  the  surface-temperature  averages  half  a 
degree  higher  than  at  sea-level. 

Insomnia.  A  larger  percentage  of  overworked  people,  Eskridge 
states,  sleep  better  in  mountain  climates  than  near  the  sea.  The 
cases  which  do  best  at  high  altitudes  are  those  who  sleep  well  from 
the  time  of  their  arrival,  aud  they  are  the  majority.  But  there  is 
truth  in  the  popular  belief  that  the  influence  of  the  Colorado  climate 
ceases  to  be  effective  in  this  respect  after  a  few  years  of  continued 
residence,  especially  if  the  individual  be  either  too  little  occupied  or 
overworked.  A  change  to  sea-level  for  a  short  time  results  in  re- 
newed improvement  on  returning. 

Eskridge  also  states  that  stimulants  usually  produce  their  effects 
more  readily,  and  with  this  I  agree ;  but  I  believe  he  should  have 
added  that  when  the  vitality  is  depressed,  and  alcohol  is  suitable, 
larger  amounts  are  needed  and  can  be  safely  taken. 

Patients  with  active  hyperaemia  of  the  brain,  with  insomnia 
or  sleeplessness  from  organic  brain-changes,  do  badly,  whereas  those 
with  passive  hypersemia  are  benefited. 

1  Transactions  of  the  American  Climatological  Association,  1891. 


164  MEDICAL   CLIMATOLOGY. 

Inherent  nervous  irritability  is  increased,  especially  in  women. 

Hysteria  is  apparently  as  frequent  and  severe  as  at  sea-level. 

Chorea,  Eskridge  believes,  yields  as  readily  to  treatment  in 
Colorado  as  elsewhere.  The  movements  on  first  arriving  are  per- 
haps exaggerated;  he  is  uncertain  about  their  frequency.  INIy  own 
belief  is  that  they  are  less  frequent. 

Neuralgia,  he  states,  is,  ou  the  whole,  less  frequent  because  of 
the  absence  of  malaria.  I  think,  however,  that  the  pain  is  more 
severe  in  proportion  to  the  conditions. 

Mig-raine.  The  first  effect  of  a  high  altitude  upon  this  disorder 
is  benericial;  but  it  frequently  returns,  in  which  case  a  change  to 
lower  ground  is  advisable. 

Epilepsy.  Eskridge  refers  to  21  cases,  5  of  which  originated 
in  Colorado;  16  were  improved.  Treatment  seemed  to  have  about 
the  same  effect  as  at  sea-level.  lu  all  he  noticed  some  improvement, 
on  first  coming,  if  they  kept  quiet.  The  writer  has  seen  several 
epileptics  very  much  improved  in  Colorado,  and  a  few  apparently 
recovered  who  were  doing  badly  before  they  came;  others  have  be- 
come worse.  My  impression  is  that  where  there  is  no  local  condi- 
tion beyond  the  reach  of  climatic  treatment,  and  the  case  is  one  for 
which  an  elevated  climate  is  otherwise  suited,  the  strong  tonic  and 
alterative  qualities  of  altitude  are  often  of  the  greatest  service. 
Possibly  one  reason  of  improvement  is  the  fact  that  epileptics  are 
better  able  to  take  bromides  with  less  depression. 

Insanity.  He  says  that  the  opportunities  for  observation  have 
not  ^^.  3u  sufficient  to'  form  an  opinion  as  to  whether  Colorado  is 
^nerciliy  beneficial  or  otherwise.  Acute  mania  is  apparently  aggra- 
vated by  the  climate,  a;id  he  has  known  such  cases  benefited  by 
being  sent  to  sea-levr'  Insanity  originating  in  Colorado  is  more  apt 
to  be  of  the  depressive  than  of  the  expansive  type.  In  a  recent 
conversation  he  said  that  he  found  from  his  own  experience  and  that 
of  other  practitioners  in  Colorado  that  the  proportion  of  melancholia 
to  mania  is  about  three  to  one,  while  Spitzka  and  other  writers 
state  that  elsewhere  it  is  about  equal. 

Inflammatory  Lesions  of  the  Brain  and  Cord,  So  far  he 
could  not  say  whether  there  was  any  difference  or  not.  Infantile 
paralysis  is  rare.  Meningitis,  tubercular  and  non-tubercular,  is  also 
rare,  the  latter  in  p'  jportion  to  the  number  of  tuberculous  persons. 

Chronic  degenerative  conditions  of  the  cord  are  perhaps  in- 
directly improved.  ,>;y    ,»v. 


OTHER  FORMS  OF  DISEASE  INFLUENCED  BY  CLIMATE.     165 

Chronic  degeneration  of  the  brain  is  quite  as  frequent  in  old- 
time  settlers  as  it  is  in  Wall  Street  men,  and  is  in  both  cases  prob- 
ably due  to  the  exciting  lives  led  by  them,  to  which,  in  the  ease 
of  the  Colorado  men,  was  added  much  physical  hardship.  This 
explanation  is  reasonable,  as  their  wives,  who  are  under  the  same 
climatic  influence,  rarely  develop  such  diseases.  Autopsies  reveal 
arteritis  as  the  usual  cause,  and  this  was  several  times  found  asso- 
ciated with  slight  chronic  meningitis. 

Apoplexy,  while  apparently  not  frequent,  is  certainly  more  likely 
to  occur  when  the  vessels  have  been  previously  weak. 

Sunstroke,  Eskridge  states,  is  practically  absent.  This  agrees 
with  my  own  observation,  and  I  found  the  same  thing  true  in  Egypt, 
at  least  south  of  the  Delta.  I  conclude  that  this  immunity  is  due 
to  the  dryness  of  the  atmosphere  in  both  climates,  which  favors 
evaporation  and  gives  relief  to  vascular  congestion. 

Leaving  these  interesting  observations  concerning  altitude  and 
nervous  diseases,  we  will  take  up  the  subject  of  neurasthenia  at 
greater  length,  as  this  nervous  disorder  oftenest  demands  climatic 
change  and  is  most  frequently  benefited  by  it. 

Neurasthenia.  The  definition  and  etiology  of  this  affection,  so 
clearly  and  concisely  given  by  Osier,  are  as  follows  : 

^'Definition.  A  condition  of  weakness  or  exhaustion  of  the  nervous 
system.  The  term,  invented  by  Beard,  covers  an  ill-defined,  motley 
group  of  symptoms,  which  may  be  either  general  and  the  expression 
of  derangement  of  the  entire  system,  or  local — that  is,  limited  to  certain 
organs.  Hence  the  terms  cerebral,  spinal,  car  liac,  and  gastric  neuras- 
thenia. In  certain  respects  it  is  the  physical  counterpart  of  in>3anit 
As  the  essential  feature  in  the  latter  condition  is  the  abnormal  response 
to  stimuli,  from  within  or  without,  upon  the  L'=;her  centres  presiding 
over  the  mind,  so  neurasthenia  appears  to  be  the  expression  of  a 
morbid,  unhealthy  reaction  to  stimuli  acting  on  the  nervous  centres 
which  preside  over  the  functions  of  organic  life.  No  hard-and-fast 
line  can  be  drawn  between  neurasthenia  and  certain  mental  states, 
particularly  hysteria  and  hypochondria. 

"  Etiology.  Although  the  causes  are  apparently  varied,  they  may 
be  classified  as  hereditary  and' acquired. 

"  (a)  Hereditary  neurasfhcnia.  We  do  not  all  start  in  life  with  the 
same  amount  of  nerve-capital.  Parents  who  l-^.ve  been  the  subjects 
of  nervous  complaints  or  of  mental  troubles  trauMnit  to  their  children 
an  orgai '     tion  which  is  defective  in  what,  for  want  of  a  better  term, 


166  MEDICAL  CLIMATOLOGY. 

we  must  call  '  nerve-force.'  Such  individuals  start  handicapped 
and  furnish  a  considerable  proportion  of  our  neurasthenic  patients. 
So  long  as  they  are  content  to  transact  a  moderate  business  with 
their  capital,  all  may  go  Avell;  but  there  is  no  reserve,  and  in  the 
emergencies  which  constantly  arise  in  the  exigencies  of  modern  life 
these  small  capitalists  go  under  and  come  to  us  bankrupt. 

"  (6)  Acquired  neurasthenia.  The  functions,  though  perverted  most 
readily  in  persons  who  hav^e  inherited  a  feeble  organization,  may  also 
be  damaged  by  exercise  which  is  excessive  in  proportion  to  the  strength 
— i.e.,  by  strain.  The  cares  and  anxieties  attendant  upon  the  gain- 
ing of  a  li«'elihood  may  be  borne  without  distress,  but  in  many  persons 
the  strain  becomes  excessive  and  is  first  manifested  as  worry.  The 
individual  loses  the  distinction  between  essentials  and  non-essentials, 
trifles  cause  annoyance,  and  the  entire  organism  reacts  with  unneces- 
sary readiness  to  slight  stimuli,  and  is  in  a  state  which  the  older 
writers  call  irritable  weakness.  If  such  a  condition  be  taken  early 
and  the  patient  given  rest,  the  balance  is  quickly  restored.  In  this 
group  may  be  placed  a  large  proportion  of  the  neurasthenics  whom 
we  see  in  this  country,  particularly  among  business  men.  Other 
causes  more  subtle,  yet  potent  and  less  easily  dealt  with,  are  the 
worries  attendant  upon  love  affairs,  religious  doubts,  and  the  sexual 
passion."^ 

After  the  due  regulation  of  rest  and  exercise  for  a  o-iven  case  of 
neurasthenia,  the  essentials  of  climatic  treatment  are  the  degree  of 
stimulation  or  sedation  needed,  the  removal  of  the  patient  from  the 
rut  into  which  he  has  fallen,  and  keeping  him  in  pure,  open  air. 

One  of  the  most  common  and  distressing  symptoms  of  neurasthenia 
is  insomnia,  and  it  may  be  stated,  as  a  general  rule,  that  where  the 
neurasthenic  sleeps  the  most  he  does  the  best — at  least  till  that 
symptom  is  overcome  and  he  is  thoroughly  rested. ' 

In  deciding  where  to  send  such  cases  a  close  inquiry  must  be  made 
into  their  past  experience  in  changing  air,  whether  they  have  recuper- 
ated best  at  the  seashore  or  on  the  hillside,  in  the  woods  or  among 
the  lakes,  on  the  warm,  dry  desert-plains,  or  at  high  altitudes,  warm 
or  cool. 

Rest  for  both  body  and  mind  is  the  first  essential  until  the  ansemia 

1  Osier :  Practice  of  Medicine. 

2  There  are  exceptions  to  this,  as  it  is  not  infrequent  to  find  neurasthenics  living  in  malarial 
districts  who  sleep  too  heavily,  and  who,  while  they  improve  in  an  elevated  climate,  yet  sleep 
more  lightly  because  the  malarial  poison  is  being  eliminated. 


OTHER  FORMS  OF  DISEASE  INFLUENCED  BY  CLIMATE.     167 

is  fairly  overcome.  The  ideal  rest  to  both  miod  and  body  for  those 
with  whom  the  sea  agrees  is  obtained  on  a  well-found  sailing-ship 
in  a  warm  latitude  or  on  placid  waters/  This  necessitates  a  good 
digestion  for  monotonous  and  simple  food,  a  non-susceptibility  to 
sea-sickness,  a  pleasant  tolerance  of  the  general  boredom  of  ship- 
board-life, and  a  philosophy  sufficient  to  overcome  the  difficulties 
sometimes  encountered  in  a  forced  companionship  with  uncongenial 
spirits.  Possessing  these  qualities,  the  neurasthenic  can  vegetate  in 
great  security  from  the  irritation  of  contiguity  to  the  busy  life  or 
worrying  circumstances  among  which  his  malady  began,  and  he  is 
also  free  from  the  temptation  to  overexertion. 

Again,  with  those  to  whom  the  sea-air  is  beneficial,  but  who  prefer 
a  shore-life  and  can  endure  more  exercise,  a  quiet  island  in  the  ocean, 
where  steamers  rarely  stop  and  which  is  free  from  the  requirements 
of  fashion,  allows  a  pleasant  alternative,  with  more  varied  interest 
and  opportunities  for  social  intercourse  and  exercise. 

If  a  more  stimulating  sea-air  is  needed,  it  is  next  best  obtained 
on  a  pleasant  seacoast,  because  there  is  less  equability  of  tempera- 
ture and  more  mobility  of  atmosphere,  owing  to  the  change  from 
sea  to  land  breezes  and  to  the  difference  in  radiation  from  the  sur- 
faces of  earth  and  ocean.  Here,  again,  both  exercise  and  amuse- 
ment can  be  more  diversified  than  on  the  island  or  the  ship. 

To  those  with  whom  sea-air  does  not  agree,  and  who  chiefiy  re- 
quire rest,  a  camp-life  in  the  woods  or  among  tlie  lakes  is  most 
desirable,  with  hunting,  fishing,  and  boating  or  pursuits  connected 
with  the  study  of  natural  history,  according  to  the  individual's 
strength. 

Again,  in  such  cases  as  are  unsuited  to  the  sea,  but  who  cannot, 
owing  to  expense  or  inconvenience,  or  because  of  some  physical  con- 
traindication, visit  high  altitudes,  the  anaemia  will  be  more  speedily 
removed  by  a  change  to  moderately  high  ground  than  by  one  involv- 
ing no  change  in  altitude.  Inland  places  of  medium  elevation  are 
best  suited  to  those  for  whom  the  seashore  or  the  higher  altitudes 
are  too  stimulating. 

Where,  however,  ansemia  is  the  prominent  symptom  or  the  under- 
lying cause,  and  where  the  nervous  susceptibility  is  acquired,  not 
inherent,  and  there  is  no  cardiac  disorder,  an  altitude  between  4000 
and  8000  feet  affords  the  surest,  speediest,  and  most  permanent 
cure. 

1  See  extract  from  Robert  Louis  Stevenson,  Section  III. 


168  MEDICAL  CLIMATOLOGY. 

A  few  years  ago  I  reported^  certain  cases  of  neurastheuia,  in  some 
of  which  the  trouble  had  been  continuous,  while  in  others  it  had 
taken  the  form  of  recurrent  attacks.  All  of  these  had  previously 
tried  low  altitudes  or  the  ocean,  aud  in  all  the  improvement  was 
much  more  rapid  and  lasting  in  Colorado  than  elsewhere. 

When  w^e  consider  the  blood-chauges  induced  by  the  diminished 
pressure,  the  greater  dryness,  and  the  increased  brilliancy  of  the  sun- 
light, this  is  not  surprising.  All  writers  on  the  effects  of  altitude 
have  noted  this ;  therefore,  where  the  other  physical  conditions  are 
favorable,  and  opportunity  offers,  a  neurasthenic  should  be  sent  to  a 
high  climate. 

The  cooler  climates  are  the  more  bracing,  the  warmer  more  seda- 
tive. 

Patients  seeking  climatic  change  must  be  especially  warned  against 
over-exercising  and  neglecting  to  obtain  at  once  the  advice  and  guid- 
ance of  a  local  physician. 

In  the  case  of  those  who  cross  the  sea  with  a  view  to  finding 
diversion  in  foreign  travel,  much  harm  is  done  by  an  excess  of  sight- 
seeing, especially  indoors  in  galleries  and  chilly  churches. 

In  no  malady  more  than  neurasthenia  is  the  advice  of  Dr.  Julius 
Braun  pertinent,  that  "you  must  consider  not  only  the  individual 
sickness,  but  the  sick  individual."^ 

Kidney  Diseases. 

Prevalence  of  kidney  diseases.  This  subject  has  been  studied 
very  carefully  by  several  writers,  especially  by  Hirsch,  Davidson, 
Hjaltelin,  Martin,  Chambers,  Morehead,  and  Dickinson.  Dickin- 
son, availing  himself  of  the  British  Government  reports,  both  civil 
and  military,  and  of  the  researches  of  other  physicians,  has  given, 
in  his  valuable  work  upon  Albuminuria^  a  digest  of  the  literature 
upon  the  prevalence  of  kidney  diseases.  He  shows  very  clearly, 
and  in  this  he  has  the  support  of  other  authorities,  that  renal  dis- 
eases are  most  prevalent  in  temperate  climates,  least  so  in  cold 
climates,  and  comparatively  rare  in  warm  climates,  if  lardaceous 
cases  be  eliminated. 

There  are  several  factors  other  than  the  climatic  which  tend  to 

1  Influence  of  Colorado  upon  Nervous  Diseases.  S.E.Solly.  Transactions  of  the  Colorado  State 
Medical  Association,  1870. 
-  See  chapter  on  Personal  Equation. 
3  A  Treatise  on  Albuminuria.     Bv  \V.  H.  Dickinson. 


OTHER  FORMS  OF  DISEASE  INFLUENCED  BY  CLIMATE.     169 

cause  this  greater  prevalence  in  temperate  climates,  such,  for  in- 
stance, as  the  greater  use  of  alcohol,  the  fact  that  the  inhabitants 
lead  more  sedentary  and  more  anxious  business-lives,  and  that  a 
larger  proportion  of  them  are  syphilitic  and  gouty;  but,  neverthe- 
less, a  thorough  inquiry  into  the  facts  clearly  shows  that  the  influence 
of  climate  is  marked.  As  an  explanation  of  this,  Dickinson  states 
the  axiom  that  the  liability  of  an  organ  to  disease,  particularly  of  an 
inflammatory  character,  bears  a  proportion  to  its  functional  activity. 
The  kidneys  have  to  do  most  work  in  a  temperate  climate,  the  skin, 
liver,  and  bowels  in  hot  countries,  and  the  lungs  in  a  cold  climate. 

Statistics  of  eight  years  for  the  British  array  show  that  the  most 
prevalent  diseases  are  tubercular  and  kiduev  troubles  in  temperate 
climates;  in  the  tropics,  malarial  affections  and  diseases  of  the  bowels 
and  liver;  and  in  the  arctic  regions,  catarrhal  disorders  of  the  res- 
piratory tract. 

Dickinson  further  demonstrates,  by  a  table'  and  by  other  evidence, 
that  where  the  temperature  of  two  climates  is  the  same,  the  least 
renal  disease  will  be  found  in  the  one  which  has  the  lowest  humidity. 

Influence  of  the  Several  Climatic  Factors.  Weber  writes  on 
this  subject  as  follows  :  "  The  separation  of  water  by  the  lungs  and 
skin  is  diminished  in  great  dampness,  and  more  work  devolves  upon 
the  kidneys,  while  their  activity  is  less  called  upon  when  the  air  is 
dry  and  warm,  and  we  must  always  pay  great  attention  to  this  in 
affections  of  the  kidneys."  Elsewhere  he  says  :  ''As  cold  air  con- 
tains less  vapor  tiian  warm,  therefore  there  is  more  loss  of  water  by 
the  lungs  when  the  air  is  cold  than  warm."  ^ 

In  warm  air  there  is  more  secretion  from  the  skin  and  less  from 
the  lungs,  and  in  cold  air  the  reverse  holds  true  ;  and  the  drier  the 
air  is,  whether  cold  or  warm,  the  more  secretion  there  is  from  one 
or  the  other  of  these  organs.  As  cold  air  is  always  proportionately 
drier  than  warm,  the  secretion  from  the  lungs  in  a  cold  air  would 
be  relatively  greater  than  that  from  the  skin  in  warm  air;  but  how 
the  greatest  possible  amount  of  water  excreted  through  the  lungs 
compares  with  the  greatest  possible  amount  excreted  through  the 
skin  has  not  been  determined. 

Again,  as  the  action  of  cold  in  contracting  the  cutaneous  vessels 
increases  the  action  of  the  kidneys  and  the  amount  of  urine  passed,* 
it   may  be  assumed,  theoretically  at  least,  that   the   kidneys   have 

1  Albuminuria,  p.  281.  -'  Ziemssen's  Climatotherapy. 

3  Landois  and  Sterling :  Physiology,  p.  426. 


170  MEDICAL  CLIMATOLOGY. 

somewhat  more  relief  in  their  work  in  a  warm,  dry,  than  in  a  cold, 
dry  air. 

Climatic  Treatment,  From  the  clinical  knowledge  at  command, 
it  would  seem  that  while  the  difference  in  value  between  the  two 
varieties  of  climates  is  not  great,  yet  if  a  warm,  dry  climate  is  other- 
wise suitable,  it  should  be  preferred,  as  a  general  rule,  for  the  relief 
of  renal  disease.  Cases  may  occur,  however,  in  which  the  bracing 
effect  of  dry  cold  is  so  desirable  for  the  cure  of  an  accompanying 
antemia  that,  in  weighing  the  advantages,  a  dry,  cold  climate  is 
preferable. 

In  both  w^arm  and  cold  climates  the  question  of  wind  is  of  the 
utmost  importance,  it  being  the  one  meteorological  element  most 
harmful  to  a  kidney-case. 

While  auy  sudden  change  of  temperature  is  attended  with  risk, 
those  expected  and  customary  differences  between  sunlight  and 
shadow,  and  day  and  night,  which  are  always  present  in  dry 
climates,  hot  or  cold,  ac3ording  to  their  degree  of  humidity,  are  of 
less  consequence,  as  they  can  be  prepared  for ;  indeed,  they  are 
often  beneficial  through  their  general  tonic  effect,  Chauges  of  tem- 
perature in  warm,  damp  climates,  however,  even  when  much  less 
extreme,  are  more  dangerous,  and,  being  more  subtle,  they  are  not 
so  easily  guarded  against ;  and  such  changes  in  cold,  damp  climates 
are  the  most  dangerous  of  all. 

With  respect  to  the  iufluence  of  elevated  climates  upon  kidney 
diseases,  there  has  been  very  little  recorded.  Dickinson  does  not 
refer  to  them  at  all ;  and  most  physicians,  when  mentioning  alti- 
tudes in  this  connection,  condemn  them  utterly,  as  did  Dr.  J.  C. 
Wilson  in  his  otherwise  excellent  paper  upon  ''  Climate  and  Bright's 
Disease." 

Analyzing  briefly  the  physical  elements  of  elevated  climates  likely 
to  influence  the  development  and  progress  of  kiduey  diseases,  we 
begin  with  diminished  atmospheric  pressure.  While  it  cannot  be 
positively  asserted  that  this  element  decreases  the  flow  of  urine,  it 
may  reasonably  be  inferred,  for  we  know  that  there  is  a  general 
tendency  of  the  blood  to  flow  to  the  skin  and  lungs  and  thus  lessen 
the  blood-pressnre  upon  the  kidneys ;  and  that  lowering  of  blood- 
pressure  reduces  the  urinary  secretion.  Further,  it  is  stated  by 
Jamiuet,  Foley,  Lange,  Pol,  Pravazy,  and  others  that  increased 
barometric   pressure  has    the   opposite   effect,^      Also    the   general 

1  A.  H.  Smith :  Compressed  Air,  p.  40. 


OTHER  FORMS  OF  DISEASE  INFLUENCED  BY  CLIMATE.     171 

equalizing  and  lowering  of  the  blood-pressure  caused  by  dimin- 
ished barometric  pressure,  in  addition  to  the  effects  before  men- 
tioned, warrants  the  belief  that  diminished  barometric  pressure 
directly  lessens  the  work  of  the  kidneys. 

Again,  the  improved  quality  of  the  blood  and  the  increased 
tissue-change  brought  about  by  the  same  climatic  factor  should  be 
favorable  to  combating  the  dyscrasia  accompanying  renal  disease. 
The  increase  of  sunlight  should  also  be  of  benefit  to  the  general  ill- 
health.  The  dryness  of  the  air,  which  is  usually  a  marked  feature 
of  such  climates,  should,  as  shown  before,  be  of  especial  value,  and 
might  to  a  great  extent  obviate  the  objections  which  could  otherwise 
be  urged  against  high  climates  if  cold,  or  their  depressing  effects 
when  warm.  It  must  be  admitted  that  wind  is  generally  a  feature 
of  elevated  climates,  except  at  special  seasons  or  in  certain  favored 
resorts  (such  as  Davos)  situated  in  valleys.  As  most  valleys,  how- 
ever, are  theoretically  and  practically  uusuited  to  renal  cases,  it  fol- 
lows that  the  benefits  ascribed  to  altitudes  are  usually  offset  by  the 
presence  of  wind,  even  if  it  be  dry  and  therefore  as  unobjectionable 
as  possible.  It  may  be  inferred  that,  if  an  elevated  climate  is 
determined  upon,  one  should  be  selected  which  is  in  all  respects 
medium — that  is,  neither  very  cold  nor  windy.  The  altitude  should 
not  be  very  great,  the  resort  should  be  situated  on  open,  sloping 
ground,  where  the  soil  is  dry,  and  the  storm-shelters  must  not  lie 
so  near  as  to  cut  off  the  sunlight  nor  to  surround  the  locality  on  all 
sides.  These  theoretical  conclusions  agree  with  my  clinical  experi- 
ence in  Colorado  and  other  elevated  climates.  Colorado  Springs  is 
often  too  cold  and  windy  in  the  winter  to  be  free  from  danger  to 
these  cases,  and  the  ideal  elevated  climate  for  them  is  to  be  found 
further  south  and  somewhat  lower  down  ;  but  my  experience,  even 
in  Colorado  Springs,  has  convinced  me  of  the  benefit  of  an  elevated 
climate  iu  certain  renal  cases.  Some  years  ago  I  reported  a  few 
cases  which  had  resided  both  in  Colorado  Springs  and  at  sea-level,  and 
the  results  were  by  no  means  adverse  to  the  altitude/ 

Later  experience  has  confirmed  the  conclusions  I  then  formed, 
which  were  as  follows  : 

First.  Acute  nephritis,  like  all  acute  inflammations,  is  not  infre- 
quent in  Colorado,  especially  in  the  mountains,  where  the  inhabi- 
tants, not  being  natives,  are  careless  of  climatic  extremes.     When 

1  Bright's  Disease  of  the  Kidneys  as  Influenced  by  the  Climate  of  Colorado.    S.  E.  Solly. 
Transactions  Colorado  State  Medical  Society,  1S84. 


172  MEDICAL  CLIMATOLOGY. 

nephritis  occurs  it  is,  moreover,  like  all  inflammations  at  an  altitude, 
more  tbau  usually  acute.  Acute  nephritis  is  not  especially  induced 
by  the  climate,  but  once  established,  it  is,  at  the  beginning,  apparently 
aggravated  by  the  altitude. 

Second.  The  direct  tendency  of  altitude  in  chronic  nephritis,  as 
in  most  chronic  diseases,  is  toward  its  cure.  This  beneficial  influ- 
ence is  doubtless  mainly  exerted  through  the  increased  action  of  the 
lungs,  and,  to  a  smaller  extent,  of  the  skin,  which  lessens  the  work 
of  the  kidneys  and  diminishes  the  renal  congestion  by  the  general 
stimulating  and  equalizing  of  the  circulation. 

The  late  Sir  Andrew  Clark  stated  to  me  that  he  found  that  kidney 
affections  frequently  developed  among  consumptives  residing  in  the 
high  Alps. 

Lardaceous  Kidney.  I  have  been  unable  to  ascertain  the  aver- 
age percentage  of  cases  of  lardaceous  kidney  among  consumptives 
generally,  therefore  I  cannot  say  what  is  the  comparative  influence 
of  climate  upon  the  disease.  In  150  cases  of  phthisis  which  I 
treated  in  Colorado  and  traced  up,  there  were  4  with  this  compli- 
cation— 2  who  were  affected  before  coming  to  Colorado  and  2  in 
whom  the  trouble  developed  after  their  arrival.  In  all  of  the 
patients  the  urine  was  frequently  tested.  It  is  quite  common  in 
Colorado  to  find  in  fatal  cases,  toward  the  end,  more  or  less  oedema, 
but  the  test-tube  and  microscope  generally  fail  to  show  any  renal 
affection  ;  doubtless  the  oedema  is  usually  caused  by  the  weakening 
heart.  Where  no  test  is  made  this  oedema  is  often  attributed  to  the 
wrong  cause,  and  I  believe  this  to  be  the  explanation  of  the  some- 
what prevalent  opinion  that  lardaceous  kidney  is  frequent  in  Colo- 
rado. In  the  scrofulous  cases,  and  cases  with  bone  tuberculosis,  lar- 
daceous disease  is  perhaps  at  least  as  frequent  here  as  elsewhere. 

AVith  respect  to  nephritis,  acute  or  chronic,  among  the  150  cases 
referred  to,  there  were  three  cases ;  two  began  in  Colorado — one 
acutely,  the  other  slowly.  The  former,  who  showed  unmistakable 
evidence  of  a  tuberculous  kidney,  is  still  in  Colorado  and  much 
improved,  though  his  uriue  contains  a  little  albumin  and  a  few  casts. 
The  latter  case  died  of  his  pulmonary  disease  and  before  his  death 
the  renal  symptoms  were  more  marked. 

In  the  present  state  of  our  knowledge  it  is  undoubtedly  safest  to 
try  first  a  warm  climate  which  may  have  a  high  humidity,  but 
must  have  a  moderate  rainfall.  The  age  of  the  patient  as  well  as 
the  stage  of  the  disease  should  greatly  influence  the  choice  between 


OTHER  FORMS  OF  DISEASE  INFLUENCED  BY  CLIMATE.     173 

a  warm  aud  a  cool  climate;  and,  again,  it  is  essential  to  know 
whether  one  may  anticipate  a  cure  or  only  an  alleviation  of  the 
malady  before  deciding  the  matter. 

With  regard  to  the  effect  of  the  Colorado  climate  upon  healthy 
kidneys,  persons  during  the  first  few  days  after  their  arrival  have 
frequently  called  my  attention  to  the  '^thickness"  of  the  urine, 
which,  upon  examination,  proved  to  contain  an  excess  of  solids, 
especially  the  urates.  These  persons  have  nsually  thought  also 
that  they  perhaps  passed  less  water,  but  certainly  more  frequently. 
This  phase  usually  disappears  in  a  few  days,  and  the  urine  returns 
to  a  normal  condition.  This  would  suggest  that  at  first  the  excre- 
tion of  water  by  the  lungs  and  skin  was  much  increased  at  the  ex- 
pense of  the  kidneys,  and  the  condition  of  the  mucous  membranes 
aud  the  parched  skin  bear  out  this  opinion. 

My  friend,  T)v.  S.  X.  Fisk,  of  Denver,  informed  me  that  from 
quantitative  and  qualitative  analyses  made  by  him  upon  specimens 
of  urine  taken  from  healthy  persons  who  were  permanent  residents 
he  found  the  uriue  usually  normal,  except  that  the  specific  gravity 
was  slightly  higher.  This  would  indicate  that  in  healthy  persons 
the  balance  between  the  excreting  organs  is  in  time  regained, 

"Certain  life-insurance  reports  gave  to  kidney  diseases  in  all 
deaths  occurring  on  the  Rocky  Mountain  plateau  aud  Pacific  slope 
a  percentage  of  but  1.6  per  cent,  against  nearly  9  per  cent,  of  all 
deaths  occurring  in  New  England  or  the  same  in  New  York." 
Thus  writes  Dr.  Francis  Atkins,  of  Las  A^egas,  New  Mexico.  He 
believes  that  early  albuminurics  do  well  on  the  Rocky  Mountain 
plateau.  He  finds  that  the  specific  gravity  of  urine  ranges  from 
1024  to  1030  in  the  life-insurance  examinations  he  made  in  Las 
Vegas.^  Dr.  Fisk^  says  that  he  was  told  by  the  vice-president  of 
the  Santa  Fe  Road  that  at  the  stock-yards  in  Chicago  it  was  rare 
to  find  diseased  livers  or  kidneys  in  cattle  coming  from  the  Rocky 
Mountain  region. 

Scarlatinal  Nephritis.  "  I  have  frequently  examined  the  urine 
during  convalescence  from  scarlatina,  but  only  remember  three  cases 
of  Bright's  disease  as  a  sequel  of  the  fever.  In  one  case  there  had 
been  exposure  and  neglect,  and  there  was  much  dropsy.  All  the 
cases,  however,  made  a  good  recovery  while  remaining  in  this 
climate.     In  practice  in  London  previously  I  found  albuminuria 

1  Transactions  of  the  American  Cliinatological  Association,  vol.  vii.  pp.  250,  251. 

2  Ibid.,  p.  253. 


174  MEDICAL  CLIMATOLOGY. 

a  common  sequel  of  scarlatina.  Iq  our  county  society  the  opinion 
of  my  colleao;ues  was  that  scarlatinal  nephritis  is  decidedly  rare  in 
this  district."^ 

Hepatic  Complications.  Sir  Henry  Thompson,  some  years 
ago,  drew  attention  to  the  importance  of  taking  the  condition  of 
the  hepatic  functions  iuto  practical  consideration  in  the  proper 
treatment  of  chronic  renal  diseases.  This,  I  believe,  is  an  especially 
important  factor  in  the  choice  of  climate! 

Diabetes.  My  views  with  regard  to  this  disease  remain  what  they 
were  when  I  expressed  them  in  Hare's  System  of  Therapeutics.^ 
"  Diabetes,  both  mellitus  and  insipidus,  would  appear  not  to  be  dis- 
eases per  se,  but  symptoms  resulting  from  disturbance  of  the  func- 
tions, or  change  in  the  structure  of  some  portion  of  the  nervous 
system  or  of  one  or  more  of  the  digestive  organs,  notably  the  liver. 
Change  of  climate,  though  not  usually  of  the  first  importance  in  the 
treatment  of  this  disease,  is  often  of  use  in  aiding  other  therapeutic 
measures." 

The  choice  must  then  be  determined  by  the  primary  causes  of  the 
affection  ;  thus  when,  in  a  full-blooded  person,  the  disease  appears  to 
have  resulted  from  high  living,  a  low,  unstimulating  climate  at  a 
spa,  such  as  Carlsbad,  where  the  waters  are  rich  in  the  salts  provo- 
cative of  increased  metabolism,  is  indicated. 

When,  again,  digestive  or  excretory  deficiencies  are  at  the  root  of 
the  matter,  and  the  patient  is  of  the  ansemic  type,  a  mountain 
climate  is  more  beneficial. 

Where  the  nervous  system  is  most  involved,  and  when  an  actual 
lesion  is  suspected,  a  warm  seashore  climate  is  generally  indicated  ; 
while  in  cases  in  which  the  nervous  symptoms  are  functional,  and 
more  or  less  ansemia  is  present,  an  altitude  will  probably  do  more  to 
retard  or  cure  the  disease. 

In  the  statistics  compiled  by  Purdy^  the  rate  of  mortality  from 
diabetes  was  very  much  higher  in  cold,  moist,  than  in  mild,  dry 
climates,  and  it  also  increased  with  the  altitude. 

I  have  watched  with  interest  the  progress  of  several  cases  of 
diabetes  during  their  residence  in  Colorado,  but  have  been  unable 
so  far  to  come  to  any  positive  conclusions  as  to  the  influence  of  alti- 
tude upon  the  disease. 

I  have  seen  some  cases  of  diabetes  which  had  not  advanced  far, 

1  Author's  article  upon  Climate  in  Hare's  System  of  Therapeutics.  -  See  page  448. 

3  Purdy  on  Diabetes,  Philadelphia,  1890. 


OTHER  FORMS  OF  DISEASE  INFLUENCED  BY  CLIMATE.     175 

aud  with  whose  hepatic  and  uervous  systems  the  cHmate  seemed  to 
agree,  do  well  in  Colorado ;  but  a  diabetic  should  be  carefully  exam- 
ined before  being  sent  to  a  high  altitude,  as  the  lack  of  equability 
in  the  climate  increases  the  risk  of  intercurrent  attacks,  and  any 
nervous  lesion  may  be  aggravated. 

Conclusions.  While  my  experience  leads  me  to  prefer  warm, 
low,  inland  climates,  such  as  those  of  Egypt  and  Arizona,  for  the 
majority  of  cases  of  chronic  renal  disease,  yet  I  have  found  that  in 
some  a  warm  seashore,  and  in  others  dry,  elevated  regions,  both  cool 
and  warm,  are  better  suited,  and  I  believe  this  is  often  because  the 
climate  insures  a  more  perfect  working  of  the  liver.  The  instruc- 
tions of  the  physician  at  the  health-resort  must  be  very  definite  and 
should  be  strictly  followed,  for  in  no  disease  is  personal  prudence  of 
greater,  importance. 

Diseases  of  the  Liver. 

Organic  Disease.  In  serious  cases  any  change  must  be  made 
with  caution  and  extreme  climates  should  be  avoided,  except  when 
the  patient  is  in  a  particularly  bad  climate,  such  as  that  of  a  tropical 
country  or  malarial  district,  in  which  case  the  needed  change  may 
be  to  a  climate  which  offers  the  sharpest  possible  contrast. 

In  functional  disease,  on  the  other  hand,  a  radical  and  extreme 
change  is  usually  of  the  greatest  benefit,  as,  for  instance,  one  from 
mountain  to  seashore,  from  laud  to  ocean,  from  a  cold  climate  to  a 
warm  one.  As  pertinent  to  the  subject  I  vvill  make  use  of  an  address 
which  I  read  before  the  Colorado  State  Medical  Society  : 

In  estimating  and  recording  the  effects  of  Colorado  upon  the  various 
organs  it  is  necessary  to  take  into  consideration  the  race  and  tem- 
perament of  the  individual,  and  it  is  probable  that  these  will  gener- 
ally explain  apparent  contradictions.  Take  the  liver,  for  example. 
It  is  frequently  asserted,  on  the  one  hand,  that  the  climate  of  Colo- 
rado causes  biliousness,  and,  on  the  other,  that  it  relieves  it.  I  have 
formed  the  impression  that  what  is  called  a  bilious  person,  one  who 
at  home  frequently  exhibits  signs  of  functional  hepatic  irregularities, 
is,  while  resident  in  this  climate,  less  subject  to  them,  and  his  skin 
is  apt  to  lose  its  yellowish  tinge;  but  persons  of  a  sanguine  or 
nervous  temperament,  in  whom  such  attacks  had  previously  been 
rare,  are,  in  Colorado,  not  uncommonly  subject  to  such  disorders. 
The  explanation  for  this  assumed  fact  appears  to  me  to  be  briefly  as 


176  MEDICAL  CLIMATOLOGY. 

follows  :  ill  the  individual  of  bilious  temperament  the  cause  of  the 
derangement  was  mainly  from  lack  of  sufficient  stimulus  to  the  liver 
through  its  circulatory  or  nervous  supply,  or  both,  and  the  ac- 
knowledged activity  of  these  two  systems,  induced  by  the  climate, 
was  the  cause  of  the  better  working  of  the  organ.  In  the  individuals 
of  sanguine  or  nervous  temperament  the  circulatory  and  nervous 
supply  of  their  livers  was  already  sufficiently  active,  and  the  climatic 
stimulus  would  be,  for  them,  excessive  and  induce  a  condition  in 
which  slight  exciting  causes  would  readily  give  rise  to  congestion 
of  the  liver  and  subsequent  derangement.^ 

In  a  dry  climate,  sacii  as  Colorado,  the  rapid  and  constant  loss 
of  moisture  from  the  tissues,  while  beneficial  and  stimulating  to 
the  action  of  the  liver  in  one  class  of  individuals,  would  probably 
be  irritating  and  hampering  to  it  in  another  class,  unless  especial 
care  were  taken  to  compensate  for  this  by  drinking  water  freely. 
Again,  while  a  dry,  warm  air  induces  free  perspiration,  yet  the 
evaporation  of  the  water  of  the  sweat,  as  soon  as  it  reaches  the  sur- 
face of  the  skin,  is  so  rapid  that  the  sweat  is  seldom  noticeable ;  but 
it  is  probable  that,  unless  the  skin  is  kept  in  an  active  condition  by 
more  than  usually  frequent  washing,  rubbing,  and  general  exercise, 
the  salts  of  the  perspiration  clog  the  pores,  and  elimination  through 
the  skin  becomes  lessened  instead  of  increased.  Consequently  waste- 
products  which  should  be  excreted  iu  this  way  may  be  returned  by 
the  circulation  to  the  liver  and  so  interfere  with  its  action. 

Dr.  Weber  and  other  writers  on  climatology  have  spoken  of  the 
favorable  influence  of  elevated  climates  upon  sluggish  circulation  in 
the  abdomen  generally,  and  it  has  been  my  observation  that  passive 
congestions  in  anaemic  persons  were  usually  benefited  at  an  altitude 
which  failed  to  agree  with  the  full-blooded  or  those  in  whom  there 
were  active  congestions  or  marked  nervous  irritability. 

The  direct  influence  of  climate  is  perhaps  more  marked  upon  the 
functions  of  the  liver  than  on  those  of  any  other  organ.  Speaking 
broadly,  persons  may  be  divided  into  those  who  become  bilious 
when  they  go  to  the  seashore  and  those  upon  whom  the  mountain- 
air  has  a  similar  effect.  It  will  be  found,  as  a  rule,  that  with  fair 
and  full-blooded  persons  the  liver  acts  best  at  the  seashore,  while 
with  the  dark-skined  and  anaemic  the  hepatic  functions  are  most 
regular  in  mountain-air. 

1  Presidential  address.    S.  E.  Solly,  M.D.     Transactions  Colorado  State  Medical  Society,  1887. 


OTHER  FORMS  OF  DISEASE  INFLUENCED  BY  CLIMATE.     177 

Attacks  of  Gallstone.  To  remove  the  conditions  upon  which 
the  formation  of  gallstones  is  dependent  certain  drugs  are  usually 
required,  notably  sulphate  or  phosphate  of  sodium;  and  clinical 
experience  indicates  that  these  are  most  effective  when  taken  in 
mineral  water.  A  suitable  spa  should  therefore  be  sought;  but  to 
get  the  best  effects  one  should  be  selected  which  possesses  the 
climatic  conditions  most  suited  to  the  patient  upon  the  general 
principles  already  laid  down.  The  success  of  treatment  at  Carlsbad 
largely  depends  upon  a  proper  consideration  of  these  general  princi- 
ples, and  its  failure  is  often  directly  traceable  to  an  ignorance  of,  or 
lack  of  regard  for,  them. 

As  balneotherapy  does  not  lie  within  the  range  of  this  treatise,  I 
cannot  pursue  this  siibject  much  further  ;  but  I  will  add  that  I  have 
been  gratified  by  the  beneficial  results  in  the  treatment  of  gallstones 
from  the  use  of  the  Shoshone  Spring  at  Manitou,  Colorado,  and  this 
in  cases  where  the  patients  had  previously  been  treated  at  Carlsbad 
without  much  benefit.  The  spring  at  Manitou  is  much  poorer 
iu  the  requisite  salts  than  the  one  at  Carlsbad,  and  often  requires 
an  artificial  addition  ;  therefore  I  cannot  but  believe  that  a  mild 
mineral  water  in  a  suitable  climate  is  sometimes  more  beneficial 
than  a  stronger  spring  in  a  place  of  which  the  climate  is  not  so 
appropriate  for  the  case. 

The  question  is,  Does  the  nervous  or  the  circulatory  system  call 
for  a  sedative  or  a  stimulating  quality  to  provoke  or  regulate  the 
necessary  metabolism  in  order  that  health  may  be  restored  ? 


Affections  of  the  Stomach. 

Dyspepsia  is  usually  amenable  to  treatment  at  home.  When 
chiefly  due  to  the  condition  of  the  mucous  membrane  the  regulation 
of  the  diet  and  habits  of  the  patient  is  of  the  most  importance,  aided 
as  may  be  required  by  drugs  or  other  therapeutic  measures,  or  by 
change  of  climate  for  the  purpose  of  taking  the  waters  at  some 
special  spa. 

Catarrh,  dilatation,  and  ulceration  of  the  stomach  do  not  usually 
of  themselves  call  for  climatic  change  ;  but  when  a  change  is  made 
it  is  necessary  to  consider  particularly  the  food  and  cooking  to  be 
found  in  the  resort  recommended.  The  change  needed  may  be  of  a 
purely  negative  character,  perhaps  to  induce  the  patient  to  drop  a 
too  engrossing  occupation,  habits  of  irregular  and  rapid  eating  or 

12 


178  MEDICAL  CLIMATOLOGY. 

of  over-indulgeuce,  and  to  take  him  away  from  the  temptations  of 
luxury  to  a  plaio  table  and  simple  living. 

Prolonged  indoor  occupations  particularly  foster  dyspepsia,  and 
therefore  the  place  where  much  pleasant  outdoor  life  and  exercise  is 
to  be  obtained  is  most  desirable,  especially  one  possessing  a  climate 
suited  to  the  action  of  the  patient's  liver. 

If  anaemia  be  present,  the  climate  must  be  selected  with  a  view  to 
curing  it.  This  disorder  demands  a  bracing  air,  and  the  seashore, 
the  moorland,  or  the  mountain  should  be  chosen,  in  accordance  with 
the  strength  and  idiosyncrasy  of  the  patient. 

While  most  gastric  cases  require  good  and  varied  diet,  plain  food 
and  rough,  open-air  life  are  best  even  for  many  delicate  dyspep- 
tics. 

An  iron  spring  which  contains  also  a  small  quantity  of  alkaline 
salts  and  is  well  charged  with  carbonic  acid  is  often  of  the  greatest 
service  to  the  anaemic  dyspeptic.  It  must  not  be  situated  in  a  hot, 
low  valley,  but  on  the  moor  or  mountain.  San  Catarina,  at  San 
Moritz,  and  the  Iron  Ute,  at  Manitou,  are  notable  examples  of  the 
best  quality  of  iron  springs  in  a  bracing  climate. 

If,  on  the  contrary,  the  dyspeptic  tends  more  to  plethora  and 
obesity,  low,  inland  climates  possessing  springs  strong  in  alkaline 
and  purgative  salts  without  iron,  which  induce  active  metabolism, 
are  the  most  suitable;  the  resort  should  also  possess  resources  for  the 
carrying  out  of  intelligent  hydrotherapy.  Saratoga  and  Glenwood  on 
this  continent  and  Carlsbad  in  Europe  are  excellent  examples  of 
such  spas. 

When  the  dyspepsia  is  largely  nervous  in  character  the  climate 
must  be  selected  with  a  view  to  its  probable  effects  upon  the  nervous 
system,  and  all  the  attendant  circumstances  must  be  carefully  studied. 

Diseases  of  the  Bo-wels. 

Chronic  diarrhoea  is  sometimes  cured  by  a  radical  change  of 
climate  without  other  therapeutic  remedies.  The  proper  change 
would  be  from  a  damp  to  a  dry,  from  a  warm  to  a  cool,  from  a  high 
to  a  low,  climate  or  vice  versa.  Heat  is  generally  more  provocative 
of  diarrhoea  than  cold,  and  dampness  than  dryness  ;  but  these  are  not 
universal  rules.  In  warm,  humid  climates  or  seasons  and  sometimes 
also  in  a  dry  atmosphere,  sudden  changes  of  temperature  will  cause 
diarrhcea  or  even  dysentery.      Such  variations  are  less  frequent   in 


OTHER  FORMS  OF  DISEASE  INFLUENCED  BY  CLIMATE.     179 

cold  climates,  especially  if  the  air  be  dry;  but  if  it  be  damj), they 
occur  oftener,  and  are  more  to  be  dreaded. 

Chronic  constipation  is  often  benefited  by  change  of  climate, 
usually  because  the  patient  lives  more  out  of  doors,  takes  more  ex- 
ercise, and  is  very  apt  to  drop  temporarily  any  unhygienic  habits. 
In  all  affections  of  the  boAvels  the  influence  of  climatic  change  upon 
the  hepatic  functions  must  be  especially  considered. 

Tuberculous  disease  of  the  bowels  or  of  any  portion  of  the 
abdomen  is  benefited  or  increased  by  climatic  change  according  to 
the  same  principles  as  those  set  out  in  the  chapter  upon  Phthisis. 

Gout  and  Rheumatism. 

Both  of  these  diseases  are  frequently  benefited  by  climatic  change. 
Gout  is  more  especially  influenced  by  diet.  Xext  to  this  in  im- 
portance come  certain  drugs  and  mineral  waters,  and  then  exercise 
and  bathing. 

The  geographical  distribution  of  gout  is  chiefly  due  to  the  diet, 
drjnkino;,  and  the  social  habits  of  the  residents  in  countries  where 
it  is  most  prevalent,  as  in  England,  for  example. 

Climate,  however,  has  some  influence  in  its  causation  and  cure. 
The  appropriate  climate  for  aiding  the  treatment  of  a  particular  case 
of  gout  depends  mainly  upon  its  effect  on  the  general  health  of  the 
patient;  but  in  deciding  the  question  certain  points  dwelt  upon  by 
Dr.  Haig  should  be  considered.^ 

He  says:  "  I  have  pointed  out  that  the  excretion  of  uric  acid  is 
greater  in  summer  than  in  winter,  and  Sydenham  speaks  of  gout  as 
a  winter  disease.  Now,  there  is  no  doubt  that  a  laboring-man  has, 
so  to  speak,  summer  all  the  year  round.  His  exertions  keep  his 
skin  constantly  active.  He  gets  rid  of  a  large  amount  of  acid  in 
this  way,  hence  the  acidity  of  his  urine  rules  low,  and  the  alkalinity 
of  his  blood  is  well  maintained;  he  therefore  excretes  uric  acid 
freely  and  retains  but  little  in  his  body;  and  so,  as  observed  by 
Cullen,  he  but  rarely  suffers  from  gout,  and  this  is  so  almost  without 
reo-ard  to  his  diet,  for  he  excretes  all  the  uric  acid  he  introduces 
as  well  as  all  that  he  forms.  As  to  the  acidity  of  the  sweat,  see 
also  Kenss,  3Ionatsch.  far  praJd.  Dermatol.,  Band  xiv.  Nos.  9,  10, 
and  12;  and  Lancet,  1892,  vol.  ii.  page  118.  A  sedentary  man 
has  not  only  higher  acidity  and  retention  of  uric  acid,  but  his  circu- 

1  Uric  Acid,  third  edition,  London,  p.  479. 


180  MEDICAL  CLIMATOLOGY. 

latioii,  especially  iu  peripheral  parts,  like  the  hands  and  feet,  is  less 
well  maintained,  and  as  a  result  the  alkalinity  of  the  fibrous  tissues 
in  such  parts  is  also  less  well  maintained. 

' '  Though,  as  I  have  said,  I  used  to  have  headaches  when  my  life 
was  not  sedentary,  I  have  no  doubt  that  I  could  indulge  in  meat 
and  beer  with  comparative  impunity  if  I  lived  the  life  of  a  laborer. 

''After  what  I  have  said  about  the  effects  of  summer,  it  is  not 
surprising  to  find  Sir  A.  Garrod  saying  (page  235),  'Gout  is  un- 
doubtedly much  less  prevalent  in  hot  than  in  temperate  climates,' 
though  no  doubt,  as  he  remarks  further  on,  food  and  habits  have 
also  something  to  do  with  its  absence. 

"  The  reverse  effects  of  cold  need  hardly  be  gone  into;  but  Sir 
A.  Garrod  says  (page  247),  '  When  cold  acts  as  an  exciting  cause 
the  effect  is  due,  at  least  in  part,  to  its  arresting  the  secretion  of  the 
skin  and  checking  the  escape  of  acid  from  the  surface,'  and  my 
experimental  experience  is  in  complete  accord  with  this  statement." 

Rheumatism.  Articular  rheumatism  is  more  common  in  a  cold 
climate  than  in  a  warm  one,  and  in  a  damp  than  in  a  dry  atmos- 
phere; but  it  occasionally  occurs  in  a  dry  climate,  especially  if  it  be 
also  hot,  like  that  of  Lower  Arizona. 

Muscular  and  nervous  rheumatism  are  perhaps  nearly  as  fre- 
quent in  dry  as  in  damp  climates.  Altitude  does  not  prevent,  and 
sometimes  even  aggravates  these  affections. 

I  believe,  as  has  so  often  been  said  in  regard  to  other  diseases,  that 
the  climatic  effect  upon  the  functions  of  the  liver  has  especially  to 
be  considered.  While  the  war  still  rages  round  the  question  of  the 
identity  or  kinship  of  gout  and  rheumatism  and  the  part  played  by 
uric  acid  in  their  causation,  it  is  difficult  to  speak  definitely  as  to 
the  role  taken  by  the  liver  in  these  diseases;  but,  as  has  been  said 
in  discussing  liver  disease,  I  believe  that  both  humidity  and  dry- 
ness have  a  great  and  direct  influence  upon  the  secretion  and  nervous 
action  of  this  organ,  and  consequently  upon  the  excretion  of  urea  or 
its  accumulation  in  the  tissues.  Again,  climate  undoubtedly  has  an 
indirect  influence  upon  the  action  of  the  liver  through  its  effect  upon 
the  functional  _^activity  of  the  skin  Variability  in  a  damp  climate, 
or  the  exaggerations  of  meteorological  variations  resulting  from  ex- 
cessive dryness,  often  cause  a  chilling  of  the  surface  of  the  body; 
thus  the  pores  are  closed,  the  excretory  functions  of  the  skin  tem- 
porarily interfered  with,  and  the  work  performed  by  the  liver 
increased. 


OTHER  FORMS  OF  DISEASE  INFLUENCED  BY  CLIMATE,     jgl 

It  may  be  stated  as  suggestive  that  it  is  a  coramoii  saying  in 
Colorado  tliat  persons  who  have  rheumatism  when  they  go  there 
lose  it,  and  those  coming  witlioiit  it  acquire  it.  This,  although  an 
exaggeration,  has  a  basis  of  trutli. 

In  rheumatism  it  is  particularly  important,  liefore  sendioo-  a 
jiatient  to  a  resort,  to  inform  one's  self  as  to  the  humidity  tables,  the 
range  of  temperature,  the  nature  of  the  soil,  and  the  ]iresence  or 
absence  of  fogs. 


SECTION  III. 


INTRODUCTION. 

The  physician  who  has  studied  the  principles  outlined  in  the 
first  section  of  this  book  can,  on  consulting  the  facts  contained  in 
this  portion,  form  for  himself  a  very  fair  opinion  of  the  climate  of 
the  resorts  mentioned,  and  be  independent  of  the  statements  of  igno- 
rant or  prejudiced  persons.  The  main  facts  necessary  to  the  forming 
of  an  opinion  are  the  elevation,  latitude,  distance  from  the  ocean, 
proximity  of  large  bodies  of  water  or  mountains,  aspect,  configura- 
tion (whether  flat,  irregular,  or  sloping),  and  the  nature  of  the  soil 
and  vegetation.  Knowing  these,  he  can  estimate  approximately  its 
general  meteorology,  even  if  he  is  unable  to  obtain  reliable  records; 
but  if  these  are  at  hand,  let  him  remember  that  humidity  is  more 
important  by  far  than  any  other  single  factor,  and  their  importance 
as  climatic  conditions  depends  upon  the  place  held  by  it.  He  must 
not  forget  also  that  weather  and  climate,  though  allied  and  inter- 
dependent, are  not  the  same  thing,  and  that  a  climate  may,  in  the 
long  run,  be  beneficial  to  a  patient  to  whom  much  of  the  weather 
is  unpleasant  and  even  adverse  if  precautions  be  not  taken. 

The  mode  of  heating  and  ventilating  houses  at  resorts  is  of  espe- 
cial importance,  because,  unless  a  proper  relation  is  maintained  be- 
tween the  house-climate  and  that  of  the  open  air,  catarrhs  and  other 
evils  are  more  prevalent  than  they  otherwise  would  be.  The  ideal 
is  to  keep  the  surface  of  the  body  warm  and  the  air  which  is 
breathed  cool.  In  Italy  and  Mexico  the  transition  from  the  warm, 
sunny,  open  air  to  the  gloomy,  vault-like  chilliness  of  the  native 
houses  is  dangerous,  unless  one  follows  the  manner  of  the  Mexican, 
who  reverses  the  usual  custom  and  puts  on  his  overcoat  when  he 
comes  indoors.  Again,  in  American  winter-resorts  the  steam-baked, 
overheated  air  of  most  hotels  unfits  the  guests  for  benefiting  by  the 
cool,  bracing  atmosphere  outside  or  combating  the  trials  of  that 
exceptionally  stormy,  chilly  weather  which  is  to  be  found  at  times 
at  all  health-resorts,  not  even  excepting  those  of  the  sunny  South. 


184  MEDICAL  CLIMATOLOGY. 

Physicians  very  properly  inquire  into  the  range  of  temperature, 
but  they  should  remember  that  its  good  or  evil  effects  can  only  be 
estimated  fairly  when  the  humidity  is  studied  with  it. 

Climates  may  be  divided  therapeutically  into  negative  and  posi- 
tive. They  are  negative  where  it  is  simply  a  question  with  the  trav- 
eller of  avoiding  perhaps  the  damp  cold  of  home  and  seeking  the 
warm  South,  hoping  to  find  the  poet's  land,  *' where  it  is  always 
afternoon" ;  thence  he  returns,  not  changed  or  toned,  but  satisfied 
to  have  escaped,  for  another  season  at  least,  the  climatic  dangers 
and  disagreeables  of  his  customary  abiding-place.  Positive  climates, 
on  the  other  hand,  are  those  which  produce  an  alterative  or  tonic 
effect.  The  two  extremes  of  climate,  sea  and  mountain,  both  do  this; 
but  sea-air  is,  for  the  most  part,  sedative  in  character,  while  moun- 
tain-air is  stimulating;  and  the  wise  physician  chooses  on  this  prin- 
ciple or  takes  a  middle  course,  and,  selecting  a  medium  climate, 
remembers,  "  In  medio  tutissima  ibis." 

In  deciding  what  order  of  sequence  appeared  to  be  best  and  most 
convenient  for  reference  to  the  climates  described  in  this  section,  the 
author  selected  the  geographical,  starting  from  the  northwest  and 
going  east  and  then  south  and  returning  by  the  west  and  north. 
This  plan  has  been  followed  so  far  as  was  practicable  in  every  quar- 
ter of  the  globe,  and  it  has  only  been  deviated  from  where  the  pre- 
scribed order  would  have  separated  certain  resorts  from  the  climatic 
groups  to  which  they  properly  belong. 

The  coast-  and  island-resorts  are  generally  described  before  the 
inland  places. 


PLATE   I. 


I 


:  Z^* 


Si  /^'^ 


"*^.. 


RELIEF  MAP  OF  NORTH  AMERICA. 


I 


fr 


-s.«ii^ 


*^ 


From  BUTLER'S  GEOGRAPHIES,  by  permission  of  e.  h.  butler  &  co.    Copyright,  1888. 


CHAPTER    X 


NOETH  AMERICA. 


It  is  difficult  for  those  who  have  not  travelled  throughout  this 
continent  to  realize  its  size  and  the  variations  of  climate  consequent 
upon  its  topography  and  its  extent  from  arctic  to  tropical  regions. 
As  compared  with  Europe,  the  stranger  would  at  first  be  struck 
with  the  dryness  of  the  climate  and  with  its  great  range.  Cities 
in  the  same  latitude  as  those  of  Europe  are  colder  by  many  degrees, 
a  striking  example  being  that  furnished  by  the  contrast  between 
Naples  and  New  York.  This  observation  is,  however,  applicable 
only  to  the  eastern  coast  of  the  continent,  the  climate  of  the  western 
coast  being  much  milder  and  more  equable.  This  is,  of  course,  due 
to  the  fact  that  while  the  Kurosiwo,  or  warm  Japan  current,  fol- 
lows almost  the  entire  western  coast,  the  Gulf-stream,  whose  warm 
waters  are  deflected  from  the  equatorial  current  near  the  Caribbean 
Sea,  turns  from  the  eastern  coast,  after  following  it  for  a  compara- 
tively short  distance,  and  flows  across  the  Atlantic  to  warm  the  coasts 
of  western  Europe. 

Charles  Maclaren,  in  an  interesting  article  on  the  American  con- 
tinent, written  for  the  Enc^dopcedia  Britannica,  gives  a  very  clear 
explanation  of  the  way  in  which  prevailing  winds  and  mountain- 
ranges  influence  a  climate,  and  especially  this  climate.  Between 
the  parallels  of  30°  north  and  30°  south  latitude  are  found  the  so- 
called  "  trade-winds,"  which  blow  from  the  east.  Beyond  these 
limits,  unless  local  causes  suffice  to  alter  the  direction,  the  prevail- 
ing winds  would  be  westerly,  which  is  the  general  direction  of  winds 
in  the  United  States.  The  barivrs  to  the  free  sweep  of  wind  are: 
first,  the  high  range  near  the  western  coast,  beginning  in  Alaska, 
known  throughout  the  continent  as  the  Cascade  and  the  Sierra 
Nevada  Mountains,  and  term'aating  in  th'  chain  which  extends 
through  the  peninsula  of  Lower  California;  secondly,  the  Rocky 
Mountain  system,  the  backbone  of  the  cc  .tinent,  which  is  con- 
tinued through  Mexico  under  the  name  of  the  Sierra  Madre;  thirdly, 
the  Appalachian  system,  arising  south  of  the  St.  Lawrence  and  ter- 
minating in  the  northern  part  of  Georgia  and  Alabama. 


186  MEDICAL  CLIMATOLOGY. 

The  general  couclu.sion  from  thi?>  would  be  that  the  west  coast  of 
Mexico  and  the  eastern  portions  of  the  more  northerly  parts  of  the 
continent  would  be  least  humid,  and,  local  differences  aside,  this  is, 
in  fact,  very  much  the  case.  It  is  true  that  the  western  coast  of 
Mexico,  as  far  as  23°  north  latitude,  is  fertile  and  well-watered, 
because  there  is  no  intervening  elevation  high  enough  to  form  an 
effectual  barrier  to  the  moisture-bearing  east  winds,  and,  also,  it  is 
thought  that  a  branch  of  the  trade-winds  is  deflected  from  that 
which  crosses  the  flat  Nicaraguan  territory  and  follows  the  west 
coast  for  some  distance;  but  from  23°  to  33°  or  34°  north  latitude 
the  western  coast  of  Mexico  and  even  the  narrow  peninsula  of 
Lower  California  are  dry,  sandy,  and  practically  without  vegeta- 
tion. 

A  marked  change  is  exhibited  on  the  west  coast  of  the  United 
States.  Here  the  prevailing  westerly  winds  have  free  sweep  over 
the  land  until  stopped  by  the  Sierra  Xevada  and  the  Cascade  ranges, 
and  bring  not  only  moisture  from  the  Pacific  Ocean,  but  the  tem- 
pering warmth  imparted  by  the  Kurosiwo.  Eastward  of  these  ranges 
the  land  is  very  dry  and  sandy,  and  Avould,  according  to  Maclaren's 
hypothesis,  continue  so  throughout  tlie  Mississippi  basin  were  it 
not  that  as  the  land  is  level  from  the  Gulf  of  ^lexico  northward, 
part  of  the  trade-wind  from  that  gulf,  unable  to  cross  the  Mexican 
Cordilleras,  is  thereby  deflected  to  the  right  and  carries  its  moisture 
to  the  region  drained  by  the  Mississippi  and  Ohio. 

The  eastern  coast  is  mainly  dependent  for  its  moisture  on  the  east 
and  northeast  winds  which  blow  off  the  Atlantic  Ocean  and  bring 
to  this  region  most  of  its  storms. 

The  climatic  divisions  of  the  country  are,  then,  three  :  first,  that 
including  the  region  from  the  Atlantic  Ocean  to  the  neighborhood 
of  the  Rocky  Mountain  system,  possessing,  especially  throughout 
the  Appalachian  Mountains,  very  marked  local  variations;  secondly, 
the  high  plateaus  and  mountainous  districts  of  the  Rocky  Moun- 
tain region,  distinguished  by  a  dry,  cold  climate,  lacking,  for  the 
most  part,  in  any  element  of  harshness,  and  showing  a  very  large 
number  of  clear  days;  thirdly,  the  district  extending  from  the  Sierra 
Xevada  Mountains  to  the  shores  of  the  Pacific,  and  possessing  a 
moderate,  equable,  humid  climate  with  mild  winters.  These  divi- 
sions will  be  found  amply  typified  in  the  selected  resorts. 


NORTH  AMERICA.  187 

Canada. 

The  superficial  extent  of  Cauada  is  nearly  equal  to  tlie  whole 
of  Europe.  It  runs  from  about  45°  north  latitude  to  the  Arctic 
Ocean,  and  has  the  two  great  oceans  of  the  world — the  Atlantic  and 
the  Pacific — for  its  eastern  and  western  boundaries. 

The  climate  of  British  Columbia  partakes  of  the  general  character 
of  that  of  the  Pacific  coast,  and  is  consequently  much  milder  than 
is  the  climate  of  the  Atlantic  provinces. 

The  climate  of  the  Atlantic  provinces  resemljles  that  of  Sweden 
and  Norway.  The  winters  are  colder  and  the  summers  hotter  than 
is  the  case  in  corresponding  latitudes  in  Europe.  January  and  Feb- 
ruary are  the  coldest  months  in  the  year.  Snow  finally  disappears 
in  Quebec  about  the  middle  of  April,  and  in  Ontario  almost  a  month 
earlier.  While  the  summers  are  hot  the  nights  are  usually  cool. 
The  dangerous  times  for  invalids  in  Canada  are  during  the  melting 
of  the  snows  and  in  the  late  autumn,  A\lien  snow  and  sleet  are  apt 
to  come  with  alternating  thaws.  When  the  winter  snows  finally 
lie  upon  the  ground  the  air,  although  cold,  is  dry  and  bracing. 

In  northeastern  Canada,  especially,  the  change  from  winter  to 
summer  is  very  sudden. 

Extensive  forests  cover  the  greater  part  of  Canada.  The  penin- 
sula formed  by  Lakes  Erie,  Huron,  and  Ontario  has  a  fertile  soil 
which  yields  large  crops,  especially  of  wheat. 

It  is  extremely  difficult  to  speak  with  definiteness  and  justice  of 
the  claims  of  Canada  as  to  its  health-resorts,  because,  even  in  regard 
to  general  climatic  characteristics,  the  area  to  be  covered  is  so  great 
and  accurate  information  is  so  scanty  and  difficult  to  obtain.  The 
local  variations,  too,  are  many,  and  would  require  close  investiga- 
tion before  their  exact  merits  and  demerits  from  this  point  of  view 
could  be  decided  upon. 

Dr.  P.  H.  Bryce,  Secretary  of  the  Ontario  Board  of  Health,  to 
whom  the  author  is  indebted  for  much  of  his  statistical  information 
on  this  subject,  divides  the  country  into  three  districts:  first,  that 
which  includes  the  provinces  of  Ontario  and  Quebec,  and  is  char- 
acterized by  the  climatic  conditions  peculiar  to  low-level  districts; 
secondly,  that  including  the  prairie-land  extending  from  Calgary  to 
the  foot  of  the  Kockies;  and,  thirdly,  the  Rock  Mountain  region 
itself,  possessing  the  characteristics  of  '^  high-level"  climates. 

As  to  the  first  region,  a  portion  of  it,  "the  central  plateau  of 


188  MEDICAL  CLIMATOLOGY. 

Ontario,"  has  a  greater  exposure  to  winds,  its  forests  having  been 
cleared  away.  Its  soil  is  a  clayey  or  gravelly  loam  overlying  lime- 
stone rock.  The  remaining  portion,  the  ]Mnskoka  district,  has 
wooded  areas,  and  its  surface  is  divided  by  rocky  ridges  with  val- 
leys lying  between.  The  forest-growths  include  balsam,  hemlock, 
and  spruce  trees. 

The  second  or  prairie  region,  having  an  elevation  of  from  400  to 
5000  feet,  is  characterized,  as  are  all  such  regions,  by  absence  of 
humidity,  great  amount  of  sunshine,  rapid  radiation  of  heat  during 
the  night,  and  high  winds.  Variability  from  day  to  day,  more 
than  between  seasons,  is  the  main  feature  of  such  climates. 

The  third  or  mountain  region,  marked  by  valleys  through  which 
flow  streams  of  greater  or  less  volume,  presents,  necessarily,  the 
greatest  variety  of  climatic  conditions.  One  valley  differs  from 
another  in  aspect,  in  elevation,  and  in  exposure  to  the  sun  and 
wind.  The  sides  of  the  foot-hills  are  often  almost  barren,  and  yet, 
as  we  rise  higher,  we  find  that  the  climate  is  damp  enough  to  sup- 
port a  considerable  forest-growth  far  up  the  slopes  of  those  loftier 
peaks  whose  summits  are  always  snow-covered. 

Dr.  Bryce,  as  an  instance  of  local  variability,  mentions  two 
climates  between  Vancouver  and  Kamloops,  one  of  which  has  an 
annual  rainfall  of  35  inches,  while  the  other  records  but  11  inches. 

Kamloops,  situated  in  British  Columbia,  in  a  broad,  open  valley 
and  on  the  line  of  the  Canadian  Pacific  Railroad,  has  an  altitude  of 
1100  feet.  The  neighborhood  offers  many  inducements  to  sports- 
men and  many  incentives  to  an  active  outdoor  life,  as  the  fishing 
and  shooting  are  good  and  the  natural  surroundings  attractive. 
The  climate  is  dry,  the  annual  rainfall  beino-  11.05  inches,  and 
the  number  of  rainy  days  per  year  only  75.  The  mean  annual 
temperature  is  46.3°  F.,  nearly  10°  higher  than  that  of  Calgary, 
and  the  average  annual  range  is  less,  being  but  22.8°.  The  mean 
daily  range  is  as  follows  : 


August. 

September. 

October. 

November. 

December. 

29.2° 

27.9= 

17.9° 

11.0° 

11.9° 

The  soil  is  light  and  gravelly  and  dries  quickly,  and  the  water- 
supply  is  pure  and  abundant.  It  is  stated  that  the  hotels  are  good 
and  the  charges  reasonable. 

Banff,  lying  on  the  line  of  the  Canadian  Pacific  Railroad  and 
surrounded  by  the  most  beautiful  mountain-scenery,  possesses  many 


NOB TH  A  MEBICA.  189 

natural  advantages.  There  is  also  a  handsome  hotel  with  spacious 
accommodations  and  a  good  cuisine.  Many  pleasant  excursions  may 
be  taken  through  the  neighborhood.  Banff,  being  situated  in  the 
Canadian  National  Park,  has  a  government  museum  which  is  well 
worth  visiting;  although  shooting  is  forbidden  within  the  limita- 
tions of  the  reservation  itself,  the  vicinity  affords  many  attractions 
to  the  sportsman,  and  there  is  good  fishing  close  at  hand.  From 
this  point  many  of  the  wonderful  parks  and  glaciers  of  the  Selkirks 
can  be  visited.  Banff  also  possesses  hot  sulphur  springs,  which  are 
recommended  in  cases  of  rheumatism,  etc. 

Calgary,  situated  in  the  province  of  Alberta,  at  an  elevation  of 
3500  feet,  has  a  dry,  sunshiny  climate.  The  annual  rainfall  is  but 
11.54  inches,  and  the  number  of  rainy  days  during  the  year  is  90. 
The  mean  annual  temperature  is  36.9°  F.,  and  the  average  annual 
range,  from  the  records  for  four  years,  is  26.1°.  In  a  pamphlet 
upon  Calgary,  Dr.  George  Macdonald  gives  the  following  monthly 
means : 


lanuary. 

February. 

March. 

April. 

May. 

June. 

6.3° 

11.8° 

14.9° 

37.5° 

48.8° 

55° 

July. 

August. 

September. 

October. 

November. 

December. 

59.6° 

58.1° 

50.9° 

40.5° 

24.7° 

14.7° 

During  the  winter  months  snow  frequently  lies  long  upon  the 
ground,  affording  good  sleighing,  and,  as  the  thermometer  may 
remain  below  zero  for  several  weeks  together,  sometimes  dropping 
to  — 25°  F.,  there  is  excellent  skating.  There  are  no  available 
wind-records,  but  it  is  stated  that  the  ''  chinook"  sometimes  blows 
here.  A  visitor  to  Calgary  reports  that  there  is  a  light  daily  breeze 
from  the  northwest.     The  mean  daily  range  in  temperature  is : 


August. 

September. 

October. 

November. 

December. 

28.9° 

30.4° 

27.1° 

23.7° 

21.6° 

There  is  no  record  of  humidity,  but  all  the  evidence  points  to  the 
conclusion  that  the  climate  is  dry.  There  are  very  few  cloudy  days, 
particularly  during  the  winter  season.  The  climate  being,  therefore, 
sunshiny,  dry,  and  bracing,  is  well  suited  to  tuberculous  patients 
who  are  sufficiently  robust  to  exercise. 

The  city  is  lighted  by  electricity  and  is  furnished  with  water- 
works and  a  .system  of  sewerage.  There  are  comfortable,  but  simple, 
accommodations,  and  the  expense  of  living  is  moderate. 

St.  Lawrence  River  Resorts.  The  pleasures  of  a  trip  down  the 
St.  Lawrence  to  Quebec  and  from  there  up  the  Saginaw  are  well 


190  MEDICAL  CLIMATOLOGY. 

known.  There  are  a  number  of  charming  resorts  from  Kingston 
to  Brockville,  on  the  shores  of  the  St.  Lawrence  opposite  the 
Thousand  Islands,  all  along  M'hich  are  numerous  fine  hotels  and 
villas.  This  district,  as  a  summer  residence,  with  a  cool,  equable, 
and  medium-moist  climate,  is  hard  to  surpass,  and  one  may  live  as 
luxuriously  or  as  simply  as  the  individual  inclination  prompts. 

Gravenhurst,  in  the  province  of  Ontario,  is  the  distributing- 
centre  for  the  resorts  of  the  Muskoka  Lake  district.  It  is  situated 
some  miles  from  Montreal,  and  has  an  elevation  of  500  feet.  The 
snowfall  here  is  heavy.  The  annual  rainfall  is  36.77  inches,  and 
the  number  of  rainy  days  throughout  the  year  is  143.  The  mean 
annual  temperature  is  41.8°  F.,  and  the  average  annual  range  is 
21.3°. 

This  country  is  much  resorted  to  for  summer  camping,  boating, 
and  fishing,  and  enjoys  a  reputation  similar  to  that  of  the  Adiron- 
dack region  for  healthfulness  and  pleasantness. 

Caledonia  Springs,  in  the  province  of  Ontario,  have  been  re- 
sorted to  for  many  years  by  sufferers  from  rheumatism,  disorderd 
liver,  kidney-troubles,  etc.  It  is  expected  that  the  Montreal  and 
Ottawa  Railroad  will  be  completed  to  Caledonia  within  a  year;  it 
has  not  heretofore  been  reached  directly  by  rail.  The  accommo- 
dations are  good,  and  many  amusements  are  provided  for  visitors. 
There  are  four  springs,  a  strong  saline  well  and  one  not  so  power- 
ful, a  carburetted  hydrogen  gas  spring,  and  one  known  as  the  white 
sulphur  spring.  The  waters  are  used  for  drinking  and  bathing.  The 
summer  climate  is  said  to  be  pleasantly  cool,  and  great  heat  is  rare. 

St,  Agathe,  in  the  province  of  Quebec,  is  situated  about  seventy 
miles  from  Montreal,  upon  a  branch  of  the  Canadian  Pacific  Rail- 
road, among  the  Laurentian  Mountains.  Its  altitude  is  about  1200 
feet.  The  hotels  are  only  moderately  good,  but  cottages  can  be 
rented,  and  here  many  of  the  residents  of  Montreal  have  their 
summer-homes.  The  village  is  situated  on  a  lake  studded  with 
islands;  the  adjacent  country  is  covered  with  pine-forests  and  the 
scenery  is  beautiful.  It  is  much  used  as  a  health-resort,  and  is  con- 
sidered to  rank,  climatically,  with  the  Adirondacks.  The  country 
offers  many  attractions  to  sportsmen  and  supplies  good  fishing  and 
shooting. 

St.  Leon  Springs,  located  between  Montreal  and  Quebec  and 
lying  about  five  miles  from  the  St.  Lawrence  River,  is  situated  in 
a  charmino-  district  of   countrv.     The   hotel-accommodations  are 


NORTH  AMERICA.  J91 

good  and  all  the  usual  amusements  of  a  summer-resort  are  provided 
for  guests.  The  waters  are  used  internally  and  externally,  and  are 
said  to  possess  aperient  and  tonic  properties  and  to  be  efficacious  in 
disorders  of  the  digestive  tract  and  iu  renal  troubles. 

Dalhousie  (New  Brunswick),  on  the  Bale  des  Chaleurs,  at  tlie 
mouth  of  the  Restigouche  River,  has  a  mild  summer  climate  and 
affords  excellent  bathing;  there  is  a  first-class  hotel,  the  "  Incharron." 
Here  is  the  starting-point  for  those  who  are  going,  in  search  of 
sport,  up  the  widely  celebrated  salmon  rivers. 

The  Region  of  the  Great  Lakes. 

The  district  lying  on  the  frontier  between  Canada  and  the  United 
States,  with  a  climate  cool,  moist,  and  equable,  abounds  in  pleasant, 
quiet,  inexpensive  resorts  which  afford  all  the  sports  and  diversions 
that  make  a  seashore-life  so  attractive.  The  climate,  too,  possesses 
some  characteristics  in  common  with  that  of  the  coast,  chief  among 
which  are  the  increased  ozone,  the  purity  of  the  air,  and  its  com- 
parative freedom  from  dust-particles  and  bacteria.  A  trip  on  these 
inland  seas,  starting,  for  instance,  from  Duluth,  crossing  the  lakes 
and  following  the  St.  Lawrence  River  down  to  Quebec,  with  an 
occasional  stop-over  at  some  of  the  pleasant  resorts  en  route,  is  a 
most  agreeable  and  healthful  experience.  The  steamers  are  fine 
boats,  and  the  euisine  is  good. 

Apropos  of  the  voyage  between  Buffalo  and  Duluth,  the  follow- 
ing remarks  in  a  recent  number  of  Outlook^  are  worthy  of  notice  : 

"  Ocean- voyages  usually  grov:  monotonous.  Not  so  a  trip  on  a 
fast  steamer  on  the  lakes,  for  there  is  a  constant  succession  of  novel- 
ties to  arouse  the  attention.  It  may  be  the  historic  Macinac,  with 
its  picturesque  headlands  and  its  decadent  fort,  last  year  finally 
abandoned  by  the  government.  It  may  be  the  St.  Clair  River, 
with  its  '  little  Venice'  of  cottages  and  club-houses,  the  resort  of 
Detroit's  water-loving  citizens,  or  a  glimpse  into  Canada,  with  a 
hint  of  French  and  Indian  in  such  an  inn  as  the  ''Ashiganikauing," 
Leon  Bellair,  proprietor,  or  a  view  of  the  famous  copper  country  on 
Lake  Superior,  with  the  smoke  rising  from  the  '  Calumet'  and 
^  Hecla,'  the  richest  copper-mines  in  the  world;  or,  here  and  there, 
a  whaleback,  a  lumberbarge,  or  a  '  sand-sucker'. 

"  It  may  be,  at  night,  the  vast  dim  luminosity  on  the  far  horizon 

1  September  26,  1896. 


192  MEDICAL  CLIMATOLOGY. 

that  indicates  some  large  city  like  Cleveland  or  Duluth,  soon  to 
appear  to  the  groups  of  watchers  on  deck. 

'^  The  tourist  who  makes  the  trip  of  the  lakes  is  sure  to  come 
back  a  wiser,  healthier,  happier  man,  with  new  ideas  as  to  ocean- 
travel  in  his  own  land,  so  to  speak,  and  with  a  memory  full  of  pleas- 
ant reminiscences  to  hearten  him  for  his  daily  work." 

The  United  States. 

This  portion  of  the  North  American  Continent,  inclusive  of  Alaska, 
extends  from  about  48°  north  latitude  at  the  northwestern  corner  of 
Washington  State,  near  Vancouver,  to  latitude  25°  north  at  Cape 
Sable,  the  extreme  southern  portion  of  Florida.  British  Columbia 
forms  the  western  half  of  the  northern  border,  and  the  Great  Lakes 
and  the  St.  Lawrence  River  the  eastern  half.  The  eastern  boundary 
is  the  Atlantic  Ocean,  the  entire  western  coast  is  washed  by  the 
waters  of  the  Pacific,  and  as  Mexico  forms  only  part  of  the  southern 
boundary,  the  rest  of  the  south  coast  bordering  on  the  Gulf  of  Mexico, 
the  country  may  be  said  to  possess  four  water-fronts,  three  of  which 
touch  upon  salt  water  and  one  upon  fresh.  All  of  these  are  resorted 
to  by  health-seekers  at  different  seasons  of  the  year. 

The  Pacific  coast  region  has  the  most  equable  and  temperate 
climate,  both  in  summer  and  in  winter,  and  this  is  particularly  true 
below  the  thirty-fifth  parallel,  where  the  climate  is  pleasant  during 
the  entire  year,  and  resembles  that  of  the  Riviera,  although  the 
temperature  is  higher  in  winter  and  lower  in  the  summer.  Above 
the  thirty-fifth  parallel  the  rainfall  is  much  augmented  and  increases 
toward  the  north,  and  the  climate  is  too  damp  and  the  winters  too 
chilly  for  most  invalids,  though  the  summers  are  usually  pleasant 
and  temperate. 

The  Atlantic  seaboard  is  used  in  summer  as  far  south  as  Old  Point 
Comfort,  and  in  winter  the  resorts  from  Atlantic  City  to  Palm  Beach 
are  much  patronized.  On  this  coast  the  range  is  greater  and  the 
climate  less  temperate  than  is  the  case  on  the  Pacific  shore. 

The  peninsula  of  Florida  is  used  by  invalids  only  during  the  cold 
season ;  but,  exclusive  of  Florida,  the  Gulf  coast  is  frequented  both 
in  winter  and  in  summer,  the  former  being  the  season  for  North- 
erners, while  the  latter  brings  an  influx  of  visitors  from  the  Southern 
States.  The  air  of  this  district  is,  however,  much  more  humid  than 
that  of  Southern  California  or  the  Riviera,  and  the  rainfall  is  greater. 


iDnaannnn  I 


Q. 


IX 


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From  butler's  geographies,  by  permission  ot  e.  h.  butler  a  co.    Copyright,  1888. 


NOB TH  AMERICA .  1 93 

Tliese  climatic  features  aud  the  temperature  are  also  somewhat  in- 
creased on  the  Florida  peninsula,  although  there  is  more  equability 
than  on  the  Gulf  coast. 


APPALACHIAN 
SYSTEM 


^.„ 


As  regards  the  interior  of  the  continent,  if  reference  is  made  to 
the  relief-map  opposite,  and  to  the  profile  shown  here,  it  will^bc 
seen  that  there  is  high  ground  near  the  eastern  coast — the  Appa- 
lachian system.  Through  these  uplands  are  situated  numbers  of 
valuable  summer-resorts,  with  cool,  though  somewhat  moist  climates, 
at  elevations  ranging  from  a  few  hundred  to  three  thousand  feet. 
A  few  of  these  resorts,  such  as  Saranac,  in  the  Adirondacks,  aud 
Asheville,  in  North  Carolina,  are  used  also  in  winter. 

In  the  South,  running  east  and  west,  are  the  Ozark  Mountains, 
of  a  more  moderate  elevation  aud  possessing  a  somewhat  drier 
climate,  but  not  at  present  much  resorted  to  by  invalids. 

In  the  western  half  of  the  continent  is  the  Cordilleran  system,  in 
which  are  situated  the  high-climate  stations  of  Colorado,  New 
Mexico,  and  Arizona.  In  these  resorts,  which  are  situated  at  alti- 
tudes ranging  from  3000  to  8000  feet,  the  precipitation  and  humidity 
are  less,  the  temperature  usually  higher,  the  hours  of  sunlight  longer, 
and  the  wind-movement  aud  the  dust  greater  than  in  the  Alpine 
stations  of  Europe.  Still  further  to  the  west  are  the  Sierra  Nevada 
and  Coast  Ranges  of  California,  which  are  beginning  to  be  much 
used  in  summer,  but  are  too  cold  and  snowy  for  pleasant  winter- 
residence  except  at  very  moderate  elevations. 

The  lowlands  of  Arizona  and  Southeastern  California  resemble  in 
climate  Egypt,  Syria,  and  other  desert-countries  of  Northern  Africa, 
though  they  are  inferior  to  those  countries  in  interest  and  accommo- 
dations. 

In  comparing  the  resources  of  American  and  European  resorts  it 
may  fairly  be  said  that  while  the  former  rival  and  even  excel  those 
of  Europe  in  places  which  are  well  established  and  most  frequented, 
this  is  not  the  case  with  the  smaller,  less-used,  and  more  recent 
resorts,  though  there  are  notable  exceptions  and  a  general  improve- 
ment is  noticeable. 


13 


CHAPTER    XI. 

EASTERN   CLIMATES. 

Atlajs'tic  Coast  Resorts. 

The  direct  iiiflueuce  of  the  Gulf-stream  on  the  eastern  Atlantic 
coast  is  less  marked  than  is  commonly  supposed.  The  hot  waters 
flowing  north  are  kept  at  a  distance  of  from  twenty  to  one  hundred 
miles  from  the  coast  by  the  counter-current  from  Baffin's  Bay,  which 
skirts  the  shores  of  North  America.  The  inner  limit  of  the  Gulf- 
stream  is  well  defined  by  a  bank  or  wall,  where  the  waters  of  the 
opposing  currents  meet  in  passing.  One  of  the  mildest  and  driest 
of  the  sea-climates  north  of  St.  Augustine  is  found  on  the  south- 
eastern shore  of  Nantucket.  The  Gulf-stream  approaches  nearer 
to  the  coast  at  this  point,  and  it  is  warmer  in  winter  and  cooler  in 
summer  than  any  other  point  ou  the  northern  Atlantic  coast. 


Table  I. 

—Atlantic  Coast  Climates 

IN  THE  United  States.^ 

Mean  monthly  temperature. 

No.  years 

of  record. 

Locality. 

Annual 
rainfall. 

January. 

July. 

Annual. 

48.4  in. 

Temp. 

Rainfall. 

Eastport 20° 

60° 

41° 

18 

18 

Portland  (Me.)     . 

•23 

69 

46 

42.7  '■ 

18 

21 

Nantucket    . 

33 

67 

48 

42.0  " 

5 

16 

Wood's  Holl 

31 

68 

49 

44.9  " 

9 

13 

Newport 

30 

50 

50.9  " 

3 

5 

Block  Island 

31 

68 

49 

44.4  " 

11 

12 

Philadelphia 

33 

76 

54 

40.9  " 

18 

22 

Baltimore    . 

34 

78 

55 

44.8  " 

19 

21 

Atlantic  City 

32 

72 

52 

42.8  " 

18 

19 

Cape  May     . 

34 

74 

53 

46.7  " 

13 

10 

Norfolk    .    . 

41 

79 

59 

52.7  " 

19 

22 

Charleston   . 

51 

82 

66 

56.3  " 

18 

21 

St.  Augustine 

'^~ 

81 

69 

49.2  " 

20 

17 

Pensacola    .... 

53 

81 

68 

."ig.o  " 

12 

13 

Cool  summer  marine  climates  are  found  along  the  New  England 
seacoast,  from  the  Islands  of  Campobello  and  Mt.  Desert  and  the 
Isles  of  Shoals,  to  Cape  Ann  and  the  Manchester  and  Beverly 
shore.     South  of  this  the  temperature  is  higher  and  the  air  more 


1  For  temperature,  rainfall,  etc.,  of  other  ocean  coast-stations— Boston,  New  York,  Jupiter, 
Key  West,  San  Francisco,  Santa  Barbara,  San  Diego— see  Table  V. 


EASTERN  CLIMATES.  I95 

humid,  and  of  the  seashore-resorts  on  the  south  coast  of  Massachu- 
setts Dr.  V.  Y.  Buwditch  says  ^Hhat  thej  are  not  often  benefi- 
cial to  people  with  pulmonary  disease,  the  prevalence  of  wet  fogs 
being  a  serious  drawbacic  to  the  climate  in  that  region.  The 
quality  of  the  climate  is  distinctly  relaxing,  and  is  often  beneficial 
to  patients  suffering  from  nervousness  and  insomnia," 

Bastport,  lying  very  near  the  Canadian  border  at  the  southeastern 
extremity  of  Maine,  is  first  described  because  it  is  the  most  northern 
resort  mentioned  and  also  because  it  has  a  weather-station  ;  its  re- 
port is  inserted  in  Table  I.  Its  meteorological  conditions  are  more 
or  less  typical  of  this  part  of  the  coast.  It  is  a  pretty  place,  with  a 
population  of  about  4000,  and  is  located  on  a  small  island  on  the 
western  shore  of  Passamaquoddy  Bay.  It  has  many  natural  advan- 
tages, among  them  being,  of  course,  facilities  for  yachting  and  fish- 
ing. Summer-life  there  is,  however,  subject  to  the  disadvantages 
contingent  upon  residence  in  a  town. 

Mount  Desert,  an  island  far-famed  as  a  summer  watering-place,  of 
which  Bar  Harbor  is  the  most  important  and  fashionable  resort,  lies 
oflP  the  coast  of  Maine  and  rises  from  sea-level  to  a  height  of  over 
1500  feet.  On  the  west  the  slope  is  gentle  and  gradual,  but  on  the 
east  the  hills  rise  precipitously  from  the  sea.  The  northern  coast 
is  very  near  the  mainland,  to  which  it  is  joined  by  a  bridge.  The 
island  is  reached  over  the  Maine  Central  Railroad,  which  connects 
with  the  Bar  Harbor  ferry,  or  by  steamer  from  New  York,  Boston, 
Eastport,  and  Bangor,  or  via  Rockland. 

Mt.  Desert  is  formed  of  granite-rock,  and  the  soil  is  notably  dry 
and  has  great  power  of  absorption.  The  climate  during  the  summer 
is  cool,  refreshing,  and  very  equable,  the  mean  temperature  being 
70°  F.  for  the  days  and  64°  for  the  nights.^  Fogs  are  rather 
frequent.  No  records  of  humidity  are  obtainable,  but  the  observa- 
tions furnished  by  Dr.  Longstreth  would  indicate  that  it  is  by  no 
means  excessive  for  a  place  so  situated.  He  writes  that  the  prevail- 
ing wind  is  from  the  west,  but  that  the  *'  high"  winds  blow  from 
the  southwest  and  bring  with  them  the  greatest  degree  of  humidity, 
and  that,  under  these  conditions,  the  mountains  are  often  cap})ed 
with  fog-clouds.  During  many  dense  fogs  the  humidity,  as  shown 
by  instruments,  is  25  or  30  points  less  than  it  is  during  a  southwest 
wind  with  general  sunshine.      It  is  only  fair  to  say  that  Dr.  Long- 

1  New  York  Medical  Record,  June  13, 1896. 


]9(J  MEDICAL  CLIMATOLOGY. 

streth's  remarks  refer  exclusively  to  Bar  Harbor  and  its  immediate 
vicinity,  and  perhaps  would  not,  he  says,  be  wholly  applicable  to 
all  parts  of  the  island  because  of  difference  in  relative  position  with 
regard  to  the  mountain  elevations,  the  ocean,  and  the  wind.  The 
water  is  usually  too  cold  for  bathing,  but  the  boating  and  fishing 
are  of  the  best.  Accommodations  are  good  all  through  the  island, 
and  at  Bar  Harbor  they  are  as  luxurious  as  could  be  desired. 
The  roads  and  foot-paths  in  this  vicinity  are  very  tolerable.  Bar 
Harbor  affords  a  delightful  social  life  and  every  kind  of  outdoor 
and  indoor  diversion ;  but  those  who  wish  to  pass  a  rather  monoto- 
nous, purely  restful  summer  will  find  more  suitable  quarters  in 
other  parts  of  the  island. 

Portland,  situated  on  the  southwestern  coast  of  Casco  Bay,  is  the 
commercial  centre  of  Maine,  and  is  also  the  centre  of  a  group  of 
attractive  seaside-resorts.  The  weather-report  is  to  be  found  in 
Table  I.  It  is  reached  from  the  south  by  the  Boston  and  Maine 
Railroad  and  from  the  north  by  the  Maine  Central  Railroad.  Its 
summer  climate  is  very  pleasant  because  of  the  sea-breeze,  which 
blows  steadily.  There  are  some  fine  buildings  and  churches  in 
Portland,  and  the  accommodations  are  good.  The  drives  through 
the  suburbs  and  environs  are  most  enjoyable. 

Scarborough  Beach,  Old  Orchard  Beach,  Kennebunkport, 
Wells  Beach,  and  York  are  coast- resorts  to  the  south.  The  hard, 
gradually  sloping  beach  at  Old  Orchard  affords  particularly  good  and 
safe  bathing. 

Portsmouth,  New  Hampshire's  only  seaport,  is  situated  on  a 
peninsula  near  the  mouth  of  the  Piscataqua  River,  and  is  almost 
surrounded  by  water.  It  is,  historically,  one  of  the  most  interest- 
ing towns  of  the  coast.  The  streets  are  broad  and  beautifully 
shaded,  and  the  residences  are  large  and  comfortable.  The  hotel- 
accommodations  are  very  good. 

The  Isles  of  Shoals,  nine  rocky  islands  lying  from  six  to  nine 
miles  from  the  mainland,  are  reached  from  Portsmouth  by  steamers 
which  leave  and  arrive  several  times  daily.  They  are  much  resorted 
to  because  of  the  pure  sea-air,  mild  and  even  temperature,  and  their 
freedom  from  that  pest  of  summer  seaside-life — the  mosquito.  There 
are  two  large  hotels  on  these  islands.  The  Isles  of  Shoals  have  been 
rendered  famous  by  the  writings  of  Lowell  and  Celia  Thaxter. 

New  Castle,  Rye  Beach,  and  Hampton  Beach,  lying  to  the 
south  of  Portsmouth,  are  well-known  resorts.      All  of  them  afford 


EASTERN  CLIMATES.  I97 

good  hotel-accommodations,  boating,  fishing,  bathing,  and  driving, 
and  Rye  Beach  is,  perhaps,  the  most  fashionable  seaside-resort  on 
the  New  England  coast. 

Cape  Ann,  projecting  from  the  east  coast  of  Massachusetts,  and 
Gloucester,  on  the  same  peninsula,  are  resorts  of  the  quieter  order. 
They  have  been  much  visited  by  artists  and  authors  on  account  of 
their  quaintness  and  picturesque  interest.     There  are  two  hotels. 

East  Gloucester,  reached  from  the  station  by  an  electric  tram- 
way, is  much  resorted  to  by  invalids  and  by  persons  who  desire  a 
quiet  summer-life.  The  accommodations,  tliough  of  a  simple  order, 
are  good. 

Plymouth  is  a  charming  old  town  which  lies  on  the  coast  forty- 
six  miles  south  of  Boston.  It  was  the  landing-place  of  the  Pilgrim 
Fathers.  It  is  reached  by  the  Old  Colony  Railroad.  Besides  its 
claims  to  historic  interest  it  possesses  all  the  attractions  of  a  watering- 
place,  and  is,  moreover,  situated  in  a  charming  country  which  gives 
opportunity  for  many  delightful  drives  and  excursions.  The  accom- 
modations are  good. 

Cape  Cod,  which  extends  eastward  from  the  coast  of  Massachu- 
setts for  miles  into  the  Atlantic  Ocean,  is,  for  the  most  part,  a  flat, 
sandy  expanse,  devoid  of  rocks  and  trees.  It  is  traversed  through- 
out its  entire  length  by  the  Old  Colony  Railroad,  and  is  much  re- 
sorted to  during  the  summer.  Its  lovers  asseverate  that  there  is  an 
especial  charm  about  the  resorts  on  ''the  Cape"  not  to  be  found 
elsewhere.  Sea-fishing,  yachting,  and  surf  and  Stillwater  bathing 
are  enjoyed  here  in  their  perfection.  Good  accommodations  of  all 
sorts  may  be  had  at  various  points  on  Cape  Cod. 

Wood's  HoU,  a  small  maritime  village  situated  at  the  southeastern 
extremity  of  Buzzard's  Bay,  is  reached  by  the  Old  Colony  Railroad 
from  Boston,  and  from  New  York  via  Fall  River.  It  is  a  station 
of  the  United  States  Fish  Commission,  has  a  marine  biological 
laboratory,  and  is  an  attractive  resort  of  the  quieter  order.  It  has 
one  hotel  and  good  accommodations  may  be  obtained.  For  weather- 
report  of  Wood's  HoU,  the  reader  is  referred  to  Table  I. 

Martha's  Vineyard.  Off  the  southern  coast  of  Massachusetts 
lies  Martha's  Vineyard,  an  island  twenty-three  miles  long  and,  at 
its  widest,  ten  miles  across.  Its  inhabitants,  like  those  of  Nantucket, 
were  formerly  engaged  in  the  whale-fisheries  ;  but  it  has  long  owed 
its  importance  to  its  advantages  as  a  summer-resort.  Most  of  the 
summer  visitors  go  to  Cottage  City,  on  the  northeastern  shore  of  the 


198  MEDICAL  CLIMATOLOGY. 

island.  A  narrow-gauge  railway  runs  southward  along  the  east  coast 
to  Edgartown  and  Katama.  There  is  every  facility  for  fishing,  sail- 
ing, and  Stillwater  bathing,  and  the  roads  are  excellent,  so  that  both 
driving  and  wheeling  are  popular  amusements.  At  Martha's  Vine- 
yard are  the  great  camp-meeting  grounds,  where  from  twenty  to 
thirty  thousand  Methodists  gather  every  August. 

Nantucket.  The  island  of  Nantucket,  sandy  and  treeless  like 
Cape  Cod,  lies  about  fifteen  miles  east  of  Martha's  Vineyard,  far 
out  in  the  Atlantic.  Steamers  ply  daily  between  Nantucket  and 
Cottage  City  and  New  Bedford,  and  there  is  a  weekly  steamer  to 
Portland  and  New  York. 

Dr.  Harold  Williams  says :  ''  The  soil  is  chiefly  sand — very  dry  and 
porous.  For  the  summer  of  1894  the  highest  temperature  was  85°  F., 
and  the  lowest  51°  F.  The  greatest  diurnal  range  was  19°.  The  mean 
relative  humidity  was  84  per  cent,  for  July,  August,  and  Septem- 
ber, 1894."  The  yearly  mean  of  relative  humidity  for  five  years 
is  81  per  cent.  The  mean  monthly  temperature  for  summer  is  64°; 
relative  humidity  83  ;  seasonal  rainfall  8.5  inches.  There  is  about 
the  same  amount  of  rainfall  as  at  Atlantic  City.  The  air  is  unusu- 
ally dry  for  sea-air  and  more  stimulating  than  that  of  the  adjacent 
"coast.  Dr.  Williams  says,  further,  that  there  are  frequent  fogs,  and 
that  the  wind  is  constant  and  often  high — blowing,  of  course,  off  the 
ocean,  no  matter  from  what  quarter  it  sets.  In  1894,  beginning 
with  July  1st,  there  were  92  consecutive  pleasant  days. 

There  are  excellent  hotels  and  boarding-houses.  One  may  also 
rent  or  buy  houses,  and  the  rates  of  living  are  low.  The  settle- 
ments are  quaint  and  picturesque,  and  the  island  bears  a  great 
variety  of  wild  flowers.  The  amusements  comprise  bathing,  row- 
ing, sailing,  fishing,  shooting,  tennis,  golf,  riding,  and  driving;  the 
blue-fishing  is  especially  fine.  A  narrow-gauge  railway  runs  from 
the  village  of  Nantucket  to  Surf  Side  and  Siasconset.  Dr.  Wil- 
liams says  :  '^  Nantucket  claims  to  be  especially  desirable  as  a 
summer  health-resort  because  of  the  purity  of  its  air,  its  coolness, 
the  small ness  of  its  diurnal  range  of  temperature,  and  the  particles 
of  sea-salt  co"ntained  in  its  air." 

Newport,  one  of  the  capitals  of  Rhode  Island  and  "■  Queen  of 
American  seaside-resorts,"  is  situated  on  a  low  plateau  in  the  south- 
western part  of  the  State.  The  town  is  an  old  settlement  of  much 
historic  interest,  but  it  is  chiefly  known  as  the  most  fashionable 
summer-resort    in    America.      The    scenery    and    surroundings    are 


EASTERN  CLIMATES.  199 

beautiful,  and  the  climate  is  equable  and  balmy,  but  humid  and 
relaxing.  Newport  has  fine  buildings  and  churches,  a  casino,  and 
a  library  of  40,000  volumes.      The  hotel-accommodations  are  good. 

Narragansett  Pier,  situated  on  the  west  shore  of  Narragansett 
Bay,  is  also  a  noted  and  fashionable  resort.  It  has  a  very  fine 
bathing- beach,  many  magnificent  hotels,  and  a  large  casino. 

Watch  Hill  is  a  favorite  resort  on  the  extreme  southwestern 
corner  of  Rhode  Island.  Here  are  to  be  found  good  bathing  and 
fishing,  beautiful  scenery,  and  hotel-accommodations  of  much  excel- 
leuce. 

Block  Island.  To  the  s  )uth  of  the  Rhode  Island  coast,  at  a 
distance  of  ten  miles  from  the  mainland,  lies  Block  Island.  It  is 
reached  by  steamer  from  Stonington,  from  New  York  direct,  or 
from  Providence  and  Newport.  The  mean  temperature  for  the 
summer  months  is  73°  F.  On  the  north  shore  are  good  beaches 
for  surf-bathing. 

The  Connecticut  shore  and  both  the  north  and  south  shores 
of  Long  Island,  are  dotted  with  attractive  little  summer-resorts 
affording  all  the  usual  seashore  diversions  and,  in  addition,  charm- 
ing drives. 

The  coast  of  New  Jersey  is  lined  with  resorts  which  are  fre- 
quented by  seekers  after  health  and  by  those  who  desire  to  escape 
from  the  disagreeables  which  form  an  accompaniment  to  summer 
residence  in  the  fiat,  inland  country  of  New  Jersey,  Pennsylvania, 
and  Delaware.  There  are  to  be  found  at  most  of  these  resorts  good 
hotel-accommodations  and  all  the  diversions  which  such  places 
usually  afford — boating,  surf-bathing,  and  fishing.  The  bathing- 
beaches  of  the  New  Jersey  coast  must  be  especially  commended. 
The  great  disadvantage  of  summer-life  upon  this  coast  is  found  in 
the  presence  of  swarms  of  mosquitoes ;  but  this  is  mitigated  when- 
ever the  breeze  blows  from  the  sea.  Of  the  New  Jersey  resorts 
may  be  mentioned  the  following  : 

Monmouth  Beach  is  chiefly  a  collection  of  private  cottages,  with 
a  club-house  and  a  casino. 

Long-  Branch,  with  which  we  may  include  Elberon,  Hollywood, 
aud  "West  End,  is  one  of  the  most  popular  watering-places  on  the 
continent,  and  one  of  the  most  expensive.  The  number  of  summer- 
guests  rises  as  high  as  50,000.  The  original  settlement  is  a  small 
village  situated  on  a  bluff  about  thirty  feet  above  the  beach.  At 
Elberon  are  located  most  of  the  fine  villas.     The  hotel- accommoda- 


200  MEDICAL  CLIMATOLOGY. 

tious  are,  as  might  be  expected,  comfortable  and  luxurious  iu  accord- 
ance with  the  requirements  of  one  of  the  most  fashionable  resorts  in 
the  country.  The  Hollywood  Hotel,  surrounded  by  trees,  is  especi- 
ally excellent,  and  is  open  all  the  year  round. 

Asbury  Park  and  Ocean  Grove  are  neighboring  resorts,  equal 
in  natural  advantages,  the  former  being  frequented  by  those  who, 
liking  the  locality,  object,  nevertheless,  to  the  exclusively  religious 
management  of  Ocean  Grove.  Each  settlement  has  a  plank-walk 
about  a  mile  loag  bordering  the  beach,  and  the  accommodations 
are  good  in  both  places. 

Other  attractive  resorts  are  Sea  Girt,  Squam,  Barnegat  (not- 
able for  the  good  shooting  which  it  affords),  Beach  Haven,  and 
Brigantine  Beach. 

Atlantic  City  is  situated  on  a  long  and  narrow  island  on  the 
New  Jersey  coast,  where  the  coast-line  bears  sufficiently  to  the  west 
to  afford  a  southeasterly  exposure  to  the  sea.  This  resort  has  a 
permanent  population  of  12,000,  which  is  increased  during  the 
summer  to  about  60,000.  It  is  ninety-five  miles,  or  about  four 
hours  by  rail,  from  New  York  City,  and  fifty-six  miles,  or  one  and 
one-quarter  hours,  from  Philadelphia. 

The  soil  is  sandy.  Snow  seldom  remains  on  the  ground  for  any 
length  of  time.  The  water-supply  is  considered  good.  Besides 
house-cisterus  for  storina;  the  rain-water  there  are  town  water- 
works,  which  bring  spring-water  from  the  mainland,  seven  miles 
distant.     There  is  a  town-system  of  sewerage. 

The  mean  monthly  temperature  aud  total  rainfall  for  Atlantic 
City,  by  seasons,  are  as  follows  : 


Winter 
Spring 
Summer 
Autumn 

There  is  a  yearly  average  of  6  days  above  90°  temperature  aud 
127  days  below  32°.  Number  of  cloudy  days,  110.  The  mean 
annual  relative  humidity  (three  years,  1891-'93)  was  81  per  cent.; 
for  winter,  81  per  cent.;  for  summer,  83  per  cent. 

The  sea-breeze  usually  begins  to  blow  about  11  a.m.  and  con- 
tinues until  nightfall.  The  mean  annual  hourly  wind-movement 
for  the  three  years  1891-'93  was  11.9  miles. 


Mean  temperature 

Total  rainfall 

(18  years). 

(mean  of  19  years) 

.     34° 

11.1  inches. 

.     47 

10.0       " 

.     70 

11.4       " 

.     55 

10.4       " 

EASTERN  CLIMATES.  201 

In  1885  a  report  of  tlie  mean  yearly  wind-movement  for  five 
years  for  Atlantic  City  and  Cape  May,  published  by  Mr.  B.  A. 
Bliindon,  observer  at  Atlantic  City,  was  as  follows  : 

Atlantic  City 82,630  miles.' 

Cape  May 130,055      " 

The  total  wind-movement  for  Atlantic  City  for  the  year  1891  was 
108,624  miles;  for  1892,  105,120  miles;  for  1893,  92,492  miles. 
It  was  in  each  case  higher  than  the  above  mean  for  five  years. 

In  the  pamphlet  just  referred  to,  two  reasons  were  advanced  on 
which  the  claim  of  "dryness'  could  be  made  for  the  climate  of 
Atlantic  City.  One  was  that  the  rainfall  was  less  than  at  any 
other  place  on  the  coast,  and  the  other  that  the  records  of  the 
hygrometers  were  not  significant,  as  the  instruments  at  that  time 
(1885)  were  but  thirteen  feet  above  the  sea  and  "affected  by  the 
spray,  during  the  strong  winds  off  the  water,  and  by  occasional  morn- 
ing mists  which  do  not  extend  back  into  town."  For  several 
years  past  (1895)  the  instruments  used  by  the  Weather  Bureau  have 
been  located  sixty-eight  feet  above  sea-level.  The  percentage  of 
relative  humidity  does  not,  however,  appear  to  read  any  lower  than 
in  the  former  records. 

Atlantic  City  has  a  number  of  advantages  as  a  resort.  It  is  easily 
accessible  from  the  large  cities  of  the  East.  The  town  is  well  built, 
possessing  markets  and  shops,  miles  of  streets  and  suburbs,  street- 
cars, aud  churches,  and  hundreds  of  hotels  and  boarding-houses  of 
every  grade.  There  is  a  good  beach  and  in  summer  excellent  sea- 
bathing. 

In  a  pamphlet  entitled  Atlantio  City  as  a  Winter  Health-resort, 
Dr.  Boardman  Reed  says:  "There  is  no  body  of  fresh  water 
nearer  than  the  Delaware  River — distant  about  sixty  miles — and 
the  salt-water  bays  to  the  landward  side  are  nearly  always  open, 
ice  seldom  forming,  except  for  a  short  time,  occasionally  in  the 
severest  winters."  Dr.  Reed  also  notes  that  the  land-winds  pass 
for  long  distances  over  dry  and  porous,  sandy  soil  before  reaching 
Atlantic  City. 

The  rainfall  is  surprisingly  regular  during  the  four  seasons.  It 
averages  3.5  inches  for  each  month  in  the  year. 

The  climate  of  Atlantic  City  is  mild  for  its  latitude.     The  winds 

1  Atlantic  City  as  a  Winter-resort.    B.  A.  Bluudon,  Sergeant  Signal  Service,  U.  S.  A.,  1885. 


202  MEDICAL  CLIMATOLOGY. 

are  bracius:,  aud  iu  winter  the  winds  from  the  sea  are  warm  winds. 
The  soil  is  dry,  and  an  absence  of  malaria  is  reported. 

During  the  cold  season,  when  the  temperature  is  low  and  the 
winds  come  from  the  west  and  northwest,  the  amount  of  humidity 
in  the  air  is  much  smaller  than  that  at  some  southern  and  warmer 
stations. 

During  the  summer,  with  the  mean  temperature  about  70°  F. 
and  the  relative  humidity  in  the  neighborhood  of  80  per  cent.,  the 
amount  of  actual  humidity  is  high,  as  may  be  expected  in  all  marine 
climates. 

Atlantic  City  has  a  plank-walk  bordering  the  beach  for  four 
miles.  Among  the  attractions  are  fishing  and  wild-fowl  shooting, 
and  there  is  a  very  pretty  casino  with  reading-,  smoking-,  and 
dancing-rooms  and  an  enclosed  piazza  overlooking  the  boardwalk 
and  the  ocean. 

Cape  May.  This  well-known  summer-resort  is  situated  at  the 
southern  end  of  the  State  of  New  Jersey,  opposite  the  entrance  to 
Delaware  Bay.  The  soil  is  gravelly,  with  sand  nnder  the  gravel, 
and  below  another  layer  of  gravel. 

The  water  for  domestic  use  is  obtained  from  wells  aud  distributed 
after  the  Holly  system.     It  is  soft  and  pleasant  to  the  taste. 

There  is  an  absence  of  extreme  temperatures  at  Cape  May.  In 
winter  there  are  rarely  any  readings  down  to  zero.  Dr.  Huntington 
Richards,  in  the  article  on  this  resort  in  Buck's  Reference  Hand- 
hook,  says  that  the  equability  of  the  temperature  at  Cape  May  is  at 
all  seasons  more  marked  than  at  Atlantic  City. 

From  the  same  authority  the  following  table  is  obtained,  based 
on  observations  taken  from  1871  to  1883  : 

Metkorological  Table  for  Cape  May — Record  for  13  Years. 

Observations  of  temperature  taken  at  7  a.m.,  3  p.m.,  11  p.m. 
Mean  relative 
humidity. 
Per  cent. 

77 
75 
80 
75 
77 

Average  number  of  cloudy  days  in  a  year,  117. 
It  is  very  windy — iu  fact,  Cape  May  is  one  of  the  windiest  sta- 
tions in  the  country. 


Mean  monthly 

temperature. 

Winter  . 

.      36° 

Spring   . 

.      49 

Summer 

.     72 

Autumn 

.     58 

Year 

.     53 

Total  rainfall. 

Wind. 

Inches. 

Miles  per  hour. 

11.9 

15.4 

11.1 

14.5 

12.8 

10.2 

11.7 

13.7 

47.6 

13.4 

EASTERN  CLIMATES.  203 

The  distance  from  Philadelphia  is  about  eighty  mile;^,  a  ride  of 
two  hours  by  rail. 

There  are  good  hotels  and  boarding-houses.  During  the  summer 
the  sea-bathing  is  one  of  the  greatest  attractions.  Cape  May  may 
be  said  to  be  rather  more  fashionable  than  Atlantic  City.  It  has  a 
magnificent  hard  bathing-beach  five  miles  in  length. 

Norfolk,  mentioned  because  its  weather-report  (Table  I.)  may  be 
taken  as  representing  this  part  of  the  coast,  is  the  second  city  of 
Virginia,  and  is  surpassed  among  the  Atlantic  ports  south  of  the 
Chesapeake  only  by  Savannah.  There  are  three  good  hotels. 
Eighteen  miles  from  Norfolk  is  Virginia  Beach,  a  seaside-resort 
surrounded  by  pine-woods.  Currituck  Sound,  thirty  miles  to  the 
south,  is  much  resorted  to  because  of  the  wild-fowl  shooting  it  affords. 

Old  Point  Comfort,  situated  on  a  peninsula  north  of  Hampton 
Roads,  is  the  site  of  the  great  fortification  known  as  Fortress  Mon- 
roe. There  are  two  hotels,  comfortable,  but  rather  expensive,  of 
one  thousand  beds  each,  and  some  cottages.  The  winter-tempera- 
ture is  rarely  below  40°  F.,  nor  does  the  summer-temperature  often 
exceed  80°.  Good  bathing,  boating,  and  ''crabbing''  are  among 
the  amusements.  The  social  life  of  the  place  is,  partly  because  of 
the  presence  of  the  garrison,  very  gay.  Old  Point  Comfort  may  be 
reached  by  railroad  or  by  steamer.  The  hotels  have  sun-galleries 
protected  by  glass.  During  the  winter  and  spring  the  place  is  resorted 
to  by  visitors  from  the  North  who  wish  to  escape  the  inclement  home- 
season,  but  during  the  summer  it  is  frequented  chiefly  by  health-  and 
pleasure-seekers  from  the  Southern  States.  The  climate  is  consid- 
ered beneficial  to  patients  recovering  from  bronchitis  and  for  sufferers 
from  nervous  troubles. 

St.  Aug-ustine,  latitude  29°  53'  north,  has  a  resident  population 
of  5000,  but  during  the  winter  the  population  of  this  popular  resort 
is  increased  to  10,000.  It  is  thirty-eight  miles  from  Jacksonville, 
two  hundred  and  forty-four  miles  north  of  Jupiter,  and  rather  more 
than  two  hundred  and  fifty  miles  from  Lake  Worth.  St.  Augus- 
tine is  the  oldest  town  in  America,  and  is  situated  on  the  Atlantic 
coast  of  Florida,  on  a  peninsula  opposite  Anastasia  Island.  The 
harbor  is  small  and  shallow,  but,  with  its  miles  of  connecting  rivers, 
is  well  adapted  for  small  boating.  The  surrounding  country  is  flat 
and  sandy  and  is  overgrown  with  scrub-palmetto.  The  average 
elevation  of  the  town  above  tidewater  is  twelve  feet.  The  older 
portions  of  the  town  have  narrow  streets  and  quaint  old   houses 


204  MEDICAL  CLIMATOLOGY. 

built  of  '^coquina"  or  shell-limestone.  In  the  modern  town  are 
some  of  the  finest  hotels  in  America.  There  are  also  beautiful  parks 
and  semi-tropical  gardens.  North  Beach  is  a  favorite  driving- 
resort.  St.  Augustine  is  a  United  States  military-post,  and  has 
guard-mount  daily  and  frequent  parades  with  the  military  band. 

The  climate  is  mild,  equable,  and  humid.  A  record  of  the  mean 
temperature  o£  St.  Augustine  for  twenty  years  (1824-'53)  was 
quoted  by  Dr.  J.  P.  Wall,  of  Tampa,  in  a  paper  read  before  the 
American  Climatological  Association  in  1891.  The  following  is  a 
summary:  monthly  mean,  winter,  58°  F. ;  spring,  68°;  summer, 
80°;  autumn,  71°;  annual,  69°;  January,  59°;  July,  81°. 

A  record  of  rainfall  in  St.  Augustine  for  seventeen  years  shows 
an  annual  mean  of  49.2  inches.  The  greatest  yearly  precipitation 
was  67.4  inches,  in  1880,  and  the  smallest  33.9  inches,  in  1851. 

The  winter  climate  of  St.  Augustine  is  partly  shown  in  the  fol- 
lowing report,  which  is  adapted  from  a  paper  prepared  by  Dr. 
Frank  F.  Smith  in  1887. 

Mean  of  records  for  tea  seasons  from  1877-78  to  1886-87  : 

Temperature,  November,  64°;  December,  58°;  January,  55°; 
February,  59°;  March,  62°;  April,  68°;  mean,  six  months,  61°. 

During  these  six  months  the  average  temperature  for  ten  seasons 
was  at  7  a.m.,  56°;  at  2  p.m.,  67°;  at  9  p.m.,  59°. 

Mean  temperature  for  winter  (December,  January,  and  Febru- 
ary) 57°.^ 

There  was  an  average  of  152  days  in  each  season  above  60°,  of 
which  90  days  were  over  70°,  The  wind  blew  from  the  east  about 
half  the  time. 

Mean  rainfall  for  six  months  (November  to  April,  inclusive)  was 
33.5  days,  of  which  rain  fell  at  night  on  19.1  days,  and  during  the 
daytime  on  14.5  days  out  of  181  days  in  each  season. 

IxLAND  Resorts. 

Maine. 

The  Rangeley  Lakes,  Among  the  inland  summer-resorts  of 
New  England  should  be  mentioned  these  famous  trout-lakes,  which 
afford  the  attractions  of  camp-life,  beautiful  scenery,  and  clear  air. 
There  are  half  a  dozen  lakes  connected  by  waterways.     The  eleva- 

1  The  formula  is  !+_ ?  +_^ +-^  . 
•   -1 


EASTERN  CLIMATES.  205 

tioii  of  the  highest  lake  is  1511  feet  above  the  sea.  Black-flies  and 
mosquitoes  are  troublesome  until  after  July. 

The  climate  is  cool  during  the  summer.  There  are  numerous 
hotels  and  camps  arouud  the  lakes,  which  are  reached  by  a  narrow- 
gauge  railroad  from  Farmington — forty-seven  miles  distant — in 
about  four  hours. 

The  little  village  of  Rangeley  affords  good  hotel-accommodations. 

The  Maine  "Woods.  The  climate  of  the  forest  country  of  Upper 
Maine  resembles  that  of  the  Adirondacks,  and  has  been  visited  for 
many  years,  both  in  summer  and  in  winter,  by  those  who  wished  to 
live  a  rough,  hearty,  outdoor  life.  The  principal  gateway  of  this 
region  is  Greenville,  at  the  southerly  end  of  Moosehead  Lake,  which 
can  be  reached  by  railway. 

Moosehead  Lake  (elevation,  1023  feet)  is  about  thirty-five  miles 
long,  with  an  average  width  of  ten  miles.  It  varies,  however,  from 
one  to  fifteen  miles  in  width.  Half-way  up  the  lake  is  the  Mt. 
Kineo  Hotel,  which  has  accommodation  for  500  guests.  The  lake 
and  its  tributary  streams  afford  good  fishing. 

From  the  north  end  of  the  lake  there  is  a  two-mile  carry  to  the 
west  branch  of  the  Penobscot  River.  By  means  of  canoes  long  trips 
can  be  made  around  Mt.  Katahdin  (5385  feet)  and  further  into  the 
pine-forest,  or  down  the  stream  to  Bangor. 

Black-flies  and  mosquitoes  are  very  troublesome  throughout  this 
region  in  summer. 

There  are  no  detailed  weather-records  for  the  forest  country.  It 
is  a  land  of  severe  winter  cold  and  heavy  snows.  The  trees  are 
pine,  spruce,  hemlock,  and  fir,  with  some  hardwood  growth  in  the 
highlands.  There  are  good  hotels  to  be  found  in  the  village  of 
Greenfield.  Good  hunting;  can  still  be  found  at  a  distance  from  the 
settlements. 

In  the  Aroostook  farming  country,  northeast  of  Moosehead 
Lake,  a  broken  record  of  temperature  for  two  years  can  be  given  for 
Houlton,  a  town  of  4000  inhabitants,  situated  near  the  New  Bruns- 
wick line  about  one  hundred  miles  from  Moosehead: 

Winter.      Spring.     Summer.    Autumn.      Year.      Max.       Min. 

Mean  for  two  years,  I        -^^o  350  g^o  43.  3go       gjo     28° 

1892-93.  i 

January,  1892,  and  June,  1893,  missing. 

Annual  rainfall  about  30  inches. 

Poland  Spring's,  a  favorite  inland  watering-place,  lies  five  miles 


206  MEDICAL  CLIMATOLOGY. 

from  Danville,  and  is  reached  from  there  by  means  of  six-horse 
coaches.  It  has  an  elevation  of  800  feet,  and  the  views  are  very 
fine.  There  are  two  hotels.  The  chief  attraction  of  the  place  lies 
in  its  mineral  springs. 

Vermont. 

Breadloaf  Inn,  in  the  Green  Mountains,  is  twelve  miles  from 
Middlebury.  It  is  very  well  kept  and  the  prices  are  extremely 
moderate.  The  hotel  stands  at  an  elevation  of  1600  feet,  and  the 
air  is  dry  and  bracing. 

New  Hampshire. 

Bethlehem  (elevation,  1459  feet).  Among  the  summer-resorts  in 
the  White  Mountains  Bethlehem  ranks  high  as  possessing  a  cool, 
pure,  and  clear  atmosphere;  a  supply  of  pure,  soft  water,  free  from 
all  danger  of  contamination ;  adequate  drainage;  freedom  from 
malarial  and  typhoid  fevers;  good  accommodations;  and  beautiful 
scenery.     The  place  is  remarkably  free  from  insect-pests. 

Dr.  W.  H.  Geddiugs,  in  1891,  prepared  a  paper  for  the  American 
Climatological  Association,  descriptive  of  Bethlehem  and  of  Maple- 
wood  (one  mile  distant),  from  which  much  of  the  following  informa- 
tion is  taken : 

The  plateau  upon  which  Bethlehem  and  Maplewood  are  located, 
formerly  known  as  Bethlehem  Street,  is  protected  by  a  range  of 
\\\g\\  hills  from  warm  south  winds.  There  is  a  fine  view  over  the 
beautiful  valley  of  the  Ammonoosuck,  w^hich  is  over  200  feet  lower, 
and  insures  good  drainage.  In  the  early  morning  the  valley  is 
often  filled  with  fog  and  mist,  while  the  plateau  above  is  bathed  in 
sunshine.  On  the  east  the  town  is  protected  by  Mount  Washington 
(elevation,  6923  feet),  twenty  miles  away,  and  by  the  peaks  of  the 
Presidential  Range.  On  the  west  the  country  is  rolling,  a  succes- 
sion of  hills  and  valleys,  with  a  distant  view  of  the  Green  Moun- 
tains. Water  is  supplied  from  a  reservoir  fed  by  springs  behind 
the  town.  A  drain-pipe  runs  through  the  streets  and  into  the  valley 
below.  The  soil  is  rich  but  rocky,  and  is  usually  covered  with 
boulders. 

There  are  a  number  of  hotels  and  boarding-houses  in  Bethlehem 
and  a  large  hotel  and  cottages  in  Maplewood. 

The  population  of  Bethlehem  is  1000.  The  summer  visitors 
are  said  to  number  10,000  or  15,000. 

The  season  is  from  the  1st  of  July  to  about  the  1st  of  September. 


EASTERN  CLIMATES.  207 

Few  people  remain  throughout  the  fine  weather  of  September  and 
October. 

The  mean  temperature  from  three  daily  observations  (7  a.m.,  2 
and  9  p.m.)  for  nine  years'  records  was  :  July,  66°  F.;  August,  65°; 
the  first  half  of  September,  63°.  The  average  temperature  for  the 
season  was  65°.  The  temperature  once  reached  90°,  but  it  rarely 
rises  above  87°.  The  mean  daily  range  for  July  and  August  for  two 
years  was  10°.  The  mean  relative  humidity  for  five  years  was  : 
July,  64  per  cent.;  August,  65  per  cent.;  first  half  of  September, 
68  per  cent.  This  record  is  lower  than  that  of  any  other  summer- 
resort  known  to  the  author  east  of  the  Rocky  Mountains.  (See 
Table  V.) 

The  normal  rainfall  is  at  the  rate  of  3|  inches  for  each  month 
of  the  season,  the  amount  being  usually  greater  in  August.  The 
prevailing  wind  comes  from  the  southwest.  There  is  no  record 
of  the  wind-velocity. 

Mosquitoes  are  troublesome  in  June,  but  are  rarely  seen  after  the 
1st  of  July.  Bethlehem  has  for  years  been  especially  noted  for 
affording  exemption  from  hay-fever.  Its  climate  is  considered  cool 
and  tonic,  with  a  tendency  to  sudden  changes. 

Jefferson  (elevation,  1440  feet),  situated  in  the  Franconia  region, 
is  to  be  classed  with  Bethlehem  as  to  accommodations,  and  is  equally 
popular.  It  is  a  station  on  the  Concord  and  Montreal  Railroad, 
and  is  two  miles  from  the  Maine  Central  Line.  The  view  from 
Jefferson  is  considered  by  many  to  be  the  finest  general  view  of  the 
White  Mountains  obtainable.  The  driv-es  and  walks  in  this  vicinity 
are  very  good. 

The  villages  near  Lake  W^innipeseogee  are  much  used  as  summer- 
resorts.      The  lake  is  traversed  by  small  steamers. 

Gilmanton,  situated  on  a  high  tableland,  is  a  favorite  resort. 
There  are  no  good  hotels,  but  there  is  one  first-class  boarding-house. 

Dublin  is  a  beautiful  village,  finely  situated  on  the  northwestern 
base  of  Mount  Monadnock,  at  an  altitude  of  1500  feet.  It  may  be 
reached  by  stage  from  Peterboro',  or  via  Harrisville  over  the  Boston 
and  Maine  Railroad.  There  is  one  first-class  hotel  and  one  thor- 
oughly good  boarding-house,  and  Dublin  possesses  also  Episcopal 
and  Unitarian  churches  and  a  fine  public  library.  The  roads 
are  good  and  the  surrounding  scenery  particularly  beautiful.  A 
body  of  water,  called  Monadnock  Lake  or  Dublin  Pond,  lying 
within  easy  reach,  affords  boating,  swimming,  fishing,  and  bathing. 


208  MEDICAL  CLIMATOLOGY. 

The  social  life  of  the  place  is  easy  and  pleasant,  and  includes  dances 
and  concerts  as  well  as  the  usual  outdoor  diversions  of  a  summer- 
resort.  There  are  frequent  strong  west  winds,  but  fogs  are  rare. 
It  is  said  that  the  climate  is  characterized  by  the  purity  of  its  air 
and  its  tonic  qualities.  Below  is  a  table  giving  meteorological  data 
(humidity  not  recorded)  : 


1893. 

Max. 

Miu. 

January 

.     45° 

—14° 

Clear 

days  13 

;  part 

cloudy  3 

February 

.     45 

—10 

<( 

ii 

13 

a 

5 

March  . 

.     53 

1 

<i 

" 

11 

a 

9 

April    . 

.     61 

17 

(1 

it 

12 

a 

"        5 

May     . 

.     85 

32 

" 

a 

14 

a 

5 

June    . 

.     86 

44 

u 

ti 

10 

li 

7 

July     . 

.     84 

46 

a 

a 

18 

(1 

"         9 

August 

.     86 

47 

i( 

i( 

16; 

a 

9 

September   . 

.     72 

37 

" 

a 

12, 

" 

6 

October 

.     70 

23 

a 

a 

10 

" 

"        3 

November    . 

.     58 

11 

it 

a 

10 

li 

5 

December     . 

.     51 

—  8 

•' 

" 

12 

" 

"        7 

Franconia  Village,  while  it  does  not  in  itself  offer  attractions  to 
the  visitoi',  is  the  point  for  reaching  several  pleasant  summer-resorts. 
Of  these,  one — Forest  Hills  Hotel — looks  down  from  an  elevation  of 
1100  feet  upon  the  village.  The  hotel  faces  south,  and  the  rooms 
and  table  are  excellent  and  reasonable  in  price.  The  views  are 
varied  and  beautiful.  The  soil  is  dry  and  sandy.  Dr.  Francis 
Bacon,  of  New  Haven,  considers  it  one  of  the  most  desirable  places 
in  the  White  Mountains,  being  especially  dry  and  bracing  for 
that  region.  There  are  golf-links,  tennis-courts,  etc.,  and  pleasant 
walks  and  drives.  Across  the  valley  on  Sunset  Hill  are  good  hotels 
and  many  private  cottages. 

Peterboro',  Jaffrey,  and  Rindge  are  resorts  lying  in  the  same 
district.  Good  farmhouse-accommodations  may  be  obtained  through- 
out this  vicinity. 

Massachusetts. 

Princeton,  Worcester  County,  is  sixty  miles  from  the  sea,  and 
has  an  elevation  of  about  1000  feet.  The  situation  is  open,  with 
a  good,  free  exposure,  and  stands  well  up  above  the  surround- 
ing country,  which,  while  hilly,  in  this  immediate  neighborhood 
slopes  rapidly  to  the  plain,  except  in  the  direction  of  Mt.  Wachusett. 
The  vicinity  abounds  in  beautiful  views  and  pleasant  drives  and 
walks.     The  air  is  bracing  and  markedly  drier  than  that  of  the  sea- 


EASTERN  CLIMATES.  209 

coast.     There  is  a  good  country  hotel,  and  excellent  plain  boarding 
can  be  obtained. 

Mt.  "Wachusett,  in  the  immediate  neighborhood,  is  somewhat 
higher  than  Princeton.  It  has  one  or  two  good  hotels  situated 
above  the  town,  and  therefore  affords  to  those  who  desire  to 
benefit  by  it,  the  more  rarefied  air  of  a  comparatively  mountainous 
district. 

Petersham,  at  a  little  distance  from  Princeton,  possesses  the  same 
general  climatic  conditions,  and,  like  Princeton,  is  an  excellent  re- 
sort during  the  summer  and  early  autumn  for  people  suffering  from 
pulmonary  trouble. 

Sharon  is  a  small  town  eighteen  miles  from  Boston,  on  the  Provi- 
dence Railroad,  with  an  elevation  of  300  to  400  feet.  The  soil  is 
gravelly  and  the  water-supply  pure,  and  there  is  an  additional  ad- 
vantage in  the  presence  of  pine-woods.  The  east  winds  of  the  coast 
are  much  tempered,  and  the  air  has  a  medium  bracing  quality  not 
noticed  at  lower  points.     It  has  a  local  reputation  for  healthfulness. 

Dr.  y.  y.  Bowditch,  of  Boston,  selected  this  region  as  the  best 
accessible  spot  for  a  sanitarium,  which  is  referred  to  more  particu- 
larly in  the  therapeutical  portion  of  this  book.  It  is  an  admirably 
conducted  and  pleasant  home  for  consumptives  of  limited  means, 
and  is  situated  on  sloping  ground  at  the  edge  of  pine-woods,  about 
a  mile  from  the  village. 

Ne-w  York. 

Adirondacks.  This  elevated  plateau  lies  in  the  northeastern 
portion  of  the  State  of  New  York.  Roughly  outlined,  it  extends 
from  the  Mohawk  Valley,  on  the  southern  boundary,  northward  one 
hundred  and  fifty  miles  to  the  St.  Lawrence  valley  and  the  Cana- 
dian line,  and  is  bounded  on  the  east  by  Lakes  George  and  Cham- 
plain  ;  the  high,  rolling  forest  country  continues  westerly  for  eighty 
or  one  hundred  miles,  covering  an  area  of  3,588,000  acres.  The 
mountains  run  in  a  southwesterly  direction  from  Lake  Champlain 
in  five  parallel  ranges  seven  or  eight  miles  apart.  The  greatest  width 
of  the  mountain-belt  is  about  forty  miles.  The  most  westerly  of 
these  ranges  forms  the  backbone  or  divide  of  the  region,  separating 
the  watershed  of  the  St.  Lawrence  River  from  that  of  the  Hudson 
River  and  Lake  Champlain.  There  are  a  number  of  peaks  rising 
over  4000  feet,  the  highest  being  Mt.  Marcy  (5345  feet)  and  :Mt. 

14 


210 


MEDICAL  CLIMA  TOL  OGY. 


Mclntire  (5200  feet).  The  mountaiu-plateau  has  a  general  elevation 
of  from  1500  to  2000  feet. 

Except  on  the  peaks,  the  entire  wilderness  is  still  well  covered 
with  forest,  although  a  vast  quantity  of  lumber  has  been  removed. 
The  proposed  reservation,  Adirondack  Park,  will  set  apart  over 
2,800,000  acres  in  the  centre  of  this  country,  of  which  over  1,500,000 
acres  are  primeval  forest  and  more  than  1,000,000  acres  lumber- 
forest.     Much  of  this  is  still  under  private  ownership. 

The  principal  tree-growth  is  pine,  balsam,  spruce,  and  hemlock, 
and  the  resinous  odor  is  very  strong. 

A  network  of  lakes  and  ponds  is  one  of  the  attractive  features  of 
the  Adiroudacks,  adding  diversity  to  the  landscape  and  affording 
easy  communication  throughout  the  interior  country  by  means  of 
light  boats. 

The  facilities  for  camping,  hunting,  and  fishing  all  through  this 
region  are  well  known.  There  are  nearly  two  hundred  comfortable 
hotels,  boarding-houses,  and  camps  scattered  through  it.*  The  prin- 
cipal resorts  are  from  ten  to  fourteen  hours'  journey  from  New  York 
City  by  rail.  The  most  important  gateways  are  Plattsburg,  Port 
Kent,  and  Westport  from  the  east;  Saratoga  on  the  south;  and 
several  stations  on  the  Adirondack  division  of  the  New  York  Cen- 
tral Railroad  from  the  west. 

A  meteorological  record  for  Saranac  Lake  for  the  year  1894  was 
kindly  furnished  to  the  author  by  Dr.  E.  R.  Baldwin,  voluntary 
observer,  from  which  tlie  following  abstract  is  taken  : 


Saranac  Lake,    i 
Weather  Station.  ,„.   ,        „     . 

Lat.  44°19'N.     Winter.   Spring. 
Elevation  1750  ft. 


Mean  monthly  "I 
temp.  (1894),   ; 

Total  rainfall. 

Cloudy  days, 


18°  43° 

7  in.    j  7.2  in. 
35  days  j  35  days 


Summer. 


63° 

10  in. 
17  days 


Autumn.    Annual. 


AAo  Aoo  U  Mean  for  Jan.20°,  min.— 15° 

**  i        ^'^     |i          "      July,  66°,  max.  91° 

10.4  in.  34.7  in.  Uncludingsnovvfall,  85Hn.- 

42  days  I  129  days  j  Stormy  days,  125 


The  coldest  month  was  February:  mean  temperature,  13°;  mini- 
mum— 31°. 

One  of  the  best  known  resorts  is  Paul  Smith's,  or  the  St.  Regis 
Lake  House  (1620  feet),  which  is  situated  on  the  north  shore  of 


'  See  hotel-list  of  the  Adirondack  Railroad  for  1895. 

-  The  snowfall  is  usually  measured  by  melting.    An  approximate  value  is  one  inch  of  water 
for  each  ten  inches  of  snow. 


EASTERN  CLIMATES.  211 

Lower  St.  Regis  Lake,  a  lovely  chain  of  lakes  about  five  miles  in 
length,  with  sandy  shores  and  very  little  rock,  well  suited  for 
camping.  This  region  is  comparatively  level,  there  being  only  one 
mountain  in  the  vicinity — St.  Regis — about  3000  feet  high. 

Saranac  Lake  Village  (elevation,  1600  feet)  is  the  largest  settle- 
ment in  the  Adirondacks,  and  the  only  winter-resort.  On  a  hillside 
one  mile  from  the  village  and  ten  miles  from  Paul  Smith's  is  the 
Adirondack  Cottage  Sanitarium  (1750  feet),  a  cluster  of  nearly 
twenty  small  cottages  and  other  buildings,  built  up  during  the  past 
ten  years  under  the  management  of  Dr.  E.  L.  Trudeau.  The  sani- 
tarium is  situated  on  a  shelf-like  plateau,  seventy-five  or  one  hun- 
dred feet  above  the  Saranac  River.  A  hill  rises  on  the  northwest 
to  a  height  of  about  one  hundred  feet,  and  at  a  considerable  distance 
north  and  northeast  is  a  range  of  the  Adirondack  Mountains. 

Saranac  Lake  can  be  reached  in  ten  hours  from  New  York  by  the 
Adirondack  division  of  the  New  York  Central  Railroad,  which  joins 
the  main  line  at  Utica. 

The  climate  of  this  region  shows  the  temperature  to  be  low  and 
steady  during  the  entire  winter.  Much  snow  falls,  and  there  are 
many  windless,  cold,  snowy  days.  The  normal  annual  rainfall  was 
stated  by  Dr.  A.  L.  Loomis,  several  years  ago,  to  be  as  high  as  55 
inches.^  Rain-  and  snow-storms  are  frequent,  although  they  are  said 
to  be  less  severe  than  on  the  coast.  Snow  lasts  from  the  middle  of 
November  to  the  middle  of  March  or  April,  varyiug  in  different 
seasons.     The  soil  is  porous  and  dries  quickly. 

There  is  a  preponderance  of  cloudy  weather  at  all  seasons,  espe- 
cially during  the  winter. 

There  are  no  records  of  the  relative  humidity  nor  of  the  wind- 
velocity,  but  the  movement  of  the  wind  is  usually  gentle,  as  might  be 
expected  in  a  forest-region,  while  the  percentage  of  humidity  is  high. 

Ampersand  (elevation,  1600  feet)  is  a  large  and  excellently  kept 
hotel  on  the  slopes  of  Lower  Saranac  Lake,  one  mile  from  the 
Saranac  Lake  Village.  It  has  attached  to  it  a  little  village  of  tenls. 
No  meteorological  data  for  this  resort  were  obtainable. 

Saranac  Inn  is  to  be  found  at  the  head  of  the  Upper  Saranac 
Lake.  It  is  reached  by  the  New  York  Central  Adirondack  Rail- 
way. It  is  a  comfortable  hostelry,  situated  upon  one  of  the  most 
picturesque  and  largest  of  the  Adirondack  lakes. 

1  The  Adirondack  Region.    A.  L.  Loomis,  M.D.    Transactions  of  the  American  Climatolo- 
gical  Association,  1879. 


212  MEDICAL  CLIMATOLOGY. 

Blue  Mountain  Lake  (elevation,  1800  feet)  is  thirty  miles  by 
turnpike  from  North  Creek  {via  Saratoga),  or  it  can  be  reached  from 
the  Adirondack  division  of  the  New  York  Central  and  Hudson  River 
Railroad,  via  Fulton  Chain,  by  lakes  and  carries.  The  lake  is  two 
miles  in  diameter,  and  lies  in  a  basin  formed  by  Blue  Mountain  on 
the  north  and  a  ridge  of  mountains  on  the  south  side,  and  on  its 
shores  are  two  large  hotels.  The  pine-forests  are  said  to  be  very 
extensive  in  this  region. 

A  table  of  seasonal  temperature  from  records  for  three  years^  is 
as  follows  : 

Winter.      Spring.    Summer.    Autumn.    Annual. 
Mean  monthly  temperature,     20°  37°  61°  41°  40° 

Meanfor  January,  18°;  for  July,  61°;  maximum,  86°;  minimum, 
—26°. 

The  prevailing  winds  are  from  the  northwest.  The  winds  are 
occasionally  high. 

Tiie  iiy-nuisauce  is  usually  over  by  July.  While  visiting  this 
country  in  June  the  author  was  agreeably  surprised  to  find  it  not 
noticeable. 

Lake  Placid  (elevation,  I860  feet),  four  miles  long  by  tw^o  miles 
wide,  with  its  close  companion.  Mirror  Lake,  and  with  numerous 
hotels  and  cottages  and  fine  mountain-scenery,  is  a  deservedly  popular 
resort.  The  beautiful  Keene  Valley  (1015  feet)  contains  a  village 
and  hotels.  In  this  valley  lie  the  Ausable  Lakes,  with  St.  Hubert's 
Inn,  a  most  comfortable  hotel ;  Raquette  Lake  (1775  feet)  and 
Adirondack  Lodge  (2160  feet),  in  a  secluded  corner  of  the  forest, 
must  also  be  mentioneJ.  In  the  Fulton  Chain  regions  are  the 
domains  of  the  Adirondack  League  Club  and  other  clubs  which 
attract  the  sportsman,  but  are  not  readily  accessible  to  invalids. 
All  these  and  dozens  of  other  equally  attractive  resorts  must  be 
dismissed  for  lack  of  space.  They  will  be  found  fully  described  in 
guide-books. 

The  climate  of  the  Adirondacks  can  only  be  described  in  the  most 
general  way,  as  there  are  no  complete  meteorological  reports  for  a 
series  of  years  covering  any  portion  of  this  well-known  region. 
Such  records  as  exist  are  far  from  adequate,  and  are  for  limited 
periods.  The  stations  sometimes  used  as  a  basis  for  estimating  the 
values  of  the  Adirondack  climates — Plattsburg,   on  Lake  Cham- 

1  The  Southern  Adirondacks.    E.  T.  Bruen,  M.D..  1886. 


EASTERN  CLIMATES. 


213 


plain,  and  Maloue  and  Potsdam,  in  the  St.  Lawrence  valley — are 
beyond  the  limits  of  the  true  Adirondack  region.  A  record  for 
Saranac  Lake  for  one  year  has  been  given  above.  This  weather- 
station was  established  November,  1893.  From  the  report  of  the 
Director  of  the  State  Meteorological  Bureau  of  New  York  for  1893 
the  following  data  were  obtained,  taken  from  the  valuable  article 
on  the  "  Climate  of  the  State  of  New  York,"  prepared  by  Mr.  E.  T. 
Turner,  Meteorologist  to  the  New  York  Weather  Bureau  : 


Northern  Plateau.  'Winter.  Spring.  Summer.  Autumn.  Annual. 


Three  stations.i 
Mean  elevation, 
1578  feet. 

Mean  monthly      1 
temperature       j 


Eight  stations. 2 
Mean  elevation, 
973  feet. 
Total  rainfall, 


43° 


8.79  in.  9.17  in.    10.87  in.     10.14  in      38.97  in. 


f  January,  16° 
i  July,         64° 

Records  of  temperature, 
average  for  3  years. 


Records  of  rainfall,  aver- 
age for  15  years. 


The  records  of  extreme  temperatures  are  incomplete,  but  the 
maximum  reported  temperature  is  89°F.  for  Constableville  (in  1889— 
'90-'91),  and  88°  for  Fenton's  Hotel,  or  "  Number  4"  (in  1889  and 
1892).  For  Saranac  Lake  the  maximum  is  91°  (1894)  and  the 
minimum  —34°  (1889). 

The  above  mean  annual  rainfall  of  39  inches  includes  melted 
snow.  The  amount  of  seasonal  rainfall  is  indicated  by  the  follow- 
ing record:  Constableville,  mean  depth,  average  of  three  years,  137 
inches  ;  Number  4,  mean  depth,  three  years,  108  inches  ;  Saranac 
Lake,  mean  depth,  two  years,  75  inches.  The  snow  lies  less  long 
in  comparatively  cleared  districts,  such  as  Saranac  Lake,  than  in  the 
more  wooded  regions. 

Li  summer  thunderstorms  from  the  eastern  Adirondacks  often  pass 
down  the  St.  Lawrence  valley.  The  interior  of  the  Adirondack 
region,  with  its  high  mountains  and  numerous  streams  and  lakes, 
appears  favorable  for  the  development  of  thunderstorms. 

Summer-rains  are  frequent  in  the  Adirondack  highlands.  Al- 
though there  are  local  variations,  a  general  increase  of  rainfall  is 

1  The  three  weather-stations  were  Lyon  Mountain  (1917  feet),  about  thirty-five  miles  north  in 
an  air-line  from  Saranac  Lake;  No.  4,  Fenton's  Hotel  (1571  feet),  about  seventy  miles  south- 
west in  an  air-line  from  Saranac  Lake ;  and  Constableville  (1246  feet),  some  thirty  miles  south- 
west from  No.  4. 

=  The  eight  stations  were  Constableville,  Lowville,  Fairfield,  Johnstown,  Pottersville,  Eliza- 
bethtown,  Keene  Valley,  and  Dannemora. 


214  MEDICAL  CLIMATOLOGY. 

found  in  the  mountain  region   over  the  Champlain  and  St.  Law- 
rence valleys. 

The  number  of  rainy  days  averages  high  during  the  year,  but 
detailed  reports  for  the  forest  or  mountain-plateau  are  lacking. 

There  are  no  published  records  of  relative  humidity  for  the  Adir- 
ondacks.  Mr.  Turner  says  in  his  report  that  the  region  of  least 
moisture  appears  to  be  the  Champlain  valley.  The  moisture  is 
much  greater  in  the  St.  Lawrence  valley,  and  in  summer  an  increase 
of  humidity  is  noticed,  with  an  increase  of  altitude  in  the  region  of 
the  mountain-plateau. 

The  humidity  appears  to  be  largely  determined,  however,  by  local 
conditions.  In  the  valleys  the  air  is  very  moist,  and  there  are  fogs 
nearly  every  morning  over  the  lakes  during  August  and  September. 
Many  of  the  hotels  throughout  the  Adirondacks  are  located  in  the 
valleys  and  near  lakes  and  rivers.  The  fact  that  the  humidity  is 
lower  in  the  Champlain  than  in  the  St.  Lawrence  valley  would  in- 
dicate that  it  is  probably  lower  in  the  eastern  than  in  the  western 
portion  of  the  Adirondack  highlands. 

The  earliest  frosts  occur  in  the  eastern  highlands.  In  the  vicinity 
of  Keene  Valley  the  first  frost  of  autumn  occurs  about  September 
20th  and  the  last  frost  of  spring  near  the  close  of  May.  It  is  some- 
times a  week  or  two  earlier  in  September  and  late  in  May  or  early 
in  June.  As  this  region  is  almost  entirely  covered  with  virgin 
forest  and  very  sparsely  settled,  it  necessarily  possesses  great  purity 
of  atmosphere,  being  especially  free  from  dust. 

The  climate  can  be  characterized  as  cold  and  moist.  It  is  cold  in 
winter,  when  the  air  is  dry  for  most  days  and  the  snow  lies  for 
months,  and  cool  and  moist  during  the  summer. 

There  are  a  large  number  of  cloudy  days,  and  the  humidity  is 
high.      The  soil  is  generally  light  and  sandy. 

The  region  surrounding  Lake  George  and  Lake  Champlain  is 
interesting  picturesquely  and  historically.  Lake  George  has  been 
favorably  known  as  a  summer-resort  for  so  many  years  that  its  attrac- 
tions need  no  special  mention.  Its  excellent  accommodations  and 
the  facilities  which  it  offers  for  boating,  fishing,  and  camp-life  have 
made  it  a  favorite  spot  with  all  classes  of  summer  visitors.  It  lies 
at  an  elevation  of  345  feet  above  sea-level,  and  is  surrounded  by 
well-timbered  mountains.  The  attractions  of  the  Lake  Champlain 
district  are  of  much  the  same  order,  but  the  elevation  of  this  sheet 
of  water  above  sea-level  is  only  100  feet.     At  Bluff  Point,  beyond 


EASTERN  CLIMATES.  215 

Port  Jackson,  stands  the  luxurious  Hotel  Cliamplain,  splendidly 
situated  so  as  to  command  views  of  the  Adirondacks,  Green  Moun- 
tains, and  Lake  Champlain. 

Richfield  Springs  lies  at  an  elevation  of  1700  feet,  and  is  dis- 
tant only  a  mile  from  the  head  of  Candarago  Lake.  It  is  reached 
over  a  branch  of  the  New  York  Central  and  Hudson  River  Rail- 
road, from  Richfield  Junction.  The  scenery  of  this  district  is  most 
picturesque ;  but  the  chief  attraction  lies  in  the  sulphur  springs, 
seventeen  in  number,  which  are  used  for  both  drinking  and  bathing. 
There  is  an  excellent  bath-house,  completed  in  1890,  which  includes 
a  swimming-basin.  The  accommodations  are  very  good,  and  boat- 
ing and  fishing,  riding  and  driving  are  among  the  amusements. 
Coaches  run  to  the  head  of  Otsego  Lake,  making  connection  with 
the  Cooperstown  steamer. 

Sharon  Springs,  lying  about  sixty  miles  west  of  Albany  and 
fourteen  miles  distant  from  Richfield  Springs,  has  an  elevation  of 
1350  feet.  It  is  situated  in  a  narrow  valley,  and  the  surrounding 
hills  rise  to  a  considerable  height,  aifording  beautiful  views.  The 
sulphur  and  chalybeate  springs  are  chiefly  used  for  bathing ;  the 
bath-houses  are  of  especial  excellence,  being  spacious  and  elaborately 
fitted  up  for  every  variety  of  baths.  The  hotel-accommodations  are 
very  good. 

Analysis  of  the  White  Sulphur  Spring  at  Sharon  Springs. 

One  gallon  contains  : 

Sulphate  of  magnesium         ....  34.000  grains. 

Sulphate  of  calcium 85.400  " 

Bicarbonate  of  magnesium  ....  24.000  " 

Chloride  of  sodium        ]  i-,  ~r.r.  ,, 
Chloride  of  magnesium  i 

Sulphurets  of  calcium  and  magnesium         .  3  000  " 


Total         ....     149.100 
Gas :  sulphuretted  hydrogen  .         .         .       20.50  cub.  inches. 

Saratoga  Springs,  in  the  eastern  part  of  New  York,  has  an 
elevation  of  300  or  400  feet  and  is  situated  in  a  valley  which  has 
a  dry,  sandy  soil.  Monthly  normal  temperatures  are  :  January, 
21°;  February,  22°;  March,  30°;  April,  44°;  May,  58°;  June, 
68°;  July,  72°;  August,  70°;  September,  62°;  October,  50°; 
November,  37°;  December,  25°.  The  mean  daily  range  is  20°. 
No  humidity-records  have  been  kept,  but  the  climate  is  said  to  be 
comparatively  dry.      There  are  few  high  winds  or  fogs.      Saratoga 


216 


MEDICAL  CLIMATOLOGY. 


is,  and  lono-  has  been,  one  of  the  most  fashionable  resorts  on  the 
continent.  It  possesses  an  electric  tramway,  schools  and  churches, 
a  good  water-supply,  and  fine  shade-trees.  The  hotels  and  board- 
ing-houses are,  as  might  be  expected,  most  excellent,  and  the  place 
affords  all  the  usual  attractions  of  resorts  of  this  order. 

The  springs  are  numerous,  some  being  chalybeate,  while  others 
contain  iodine  or  sulphur,  but  in  all  of  them  carbonic  acid  gas  is 
noticeably  strong.  Their  temperature  ranges  from  45°  to  50°  F. 
They  are  both  tonic  and  cathartic,  and  are,  for  the  most  part, 
pleasant  to  drink. 

ANALYSIS   OF   THE   CONGKESS   SPRING   AT   SARATOGA. 

One  gallon  contains  : 

Bicarbonate  of  lithium 
Bicarbonate  of  sodium 
Bicarbonate  of  magnesium 
Bicarbonate  of  calcium 
Bicarbonate  of  strontium 
Bicarbonate  of  barium 
Bicarbonate  of  iron 
Chloride  of  sodium 
Chloride  of  potassium 
Sulphate  of  potassium 
Phosphate  of  sodium 
Biborate  of  sodium 
Bromide  of  sodium 
Iodide  of  sodium  . 
Fluoride  of  calcium 
Alumina 
Silica 


Gas 


Total 
carbonic  acid 


4.761 

grains. 

10.775 

i< 

121.757 

(f 

143.399 

C( 

trace. 

0.928 

grain. 

0.340 

(( 

400.444 

grains. 

8.049 

a 

0.889 

grain. 

0.016 

(( 

trace. 

8.559 

grains. 

0.138 

grain. 

trace. 

trace. 

0.840 

grain. 

700.895 

grains. 

392.289  cub.  inches 

New  Jersey. 

The  Pine  Belt.  Running  through  the  centre  of  the  State  of  New 
Jersey  is  a  sandy  strip  of  land,  which  was  described  by  Dr.  I.  H. 
Piatt,  of  Lakewood,^  as  sixty  miles  in  length  and  from  eight  to 
twenty  miles  in  breadth,  reaching  from  Freehold  (Monmouth 
County)  almost  to  Vineland  (Cumberland  County).  The  soil 
varies  from  light  sandy  loam  to  clear  beach-sand.  Extensive  pine- 
forests  are  a  prominent  feature  of  this  region. 


1  The  Pine  Belt  of  New  Jersej-.    Isaac  Hull  Piatt,  M.D. 
Climatological  Association,  1889. 


Transactions  of  the   American 


EASTERN  CLIMATES.  217 

Lakewood  lies  ten  miles  from  the  sea  and  one  mile  from  the 
border  of  the  sandy  strip  under  consideration,  with  which  it  is 
identical  in  soil  and  climate.  It  is  the  only  place  affording  good 
accommodations,  and  has  several  large  hotels  and  a  number  of  cot- 
tages. Lakewood  is  sixty  miles,  or  one  and  one-half  hours  by  rail, 
from  New  York  City,  and  has  become  well  known  as  a  winter- 
resort.  The  temperature  is  usually  ten  or  twelve  degrees  warmer 
than  in  New  York.  The  town  is  from  sixty  to  one  hundred  feet 
above  the  sea,  situated  on  the  southern  slope  of  a  low  ridge,  which 
forms  a  shelter  from  northerly  and  northwesterly  winds.  Pleasant 
walks  and  drives  have  been  laid  out  through  the  woods.  The  pines 
are  thickest  to  the  north  and  west. 

The  town  is  supplied  with  water  from  the  Metedeconk  River. 
There  is  a  fine  spring  of  pure  water  about  a  mile  from  the  village. 
The  town  has  a  system  of  drainage. 

No  meteorological  record  for  Lakewood  could  be    obtained. 

Dr.  Piatt  gave  a  summary  of  the  record  for  Vineland,  which  is 
sixty  miles   southwest  of   Lakewood  and  twenty-five  miles  inland 
from  the  sea.      In  its  physical  features,  however,  it  is  almost  iden 
tical  with  the  Pine  Belt  region,  from  which  it  is  separated  by  the 
strip  of  damp  soil  that  lies  between  the  town  and  the  Pine  Belt. 

Vineland's  annual  record  for  ten  years  : 

Temperature.  Rainfall. 

, ' ,  Relative  , ' > 

Mean.        Max.  Min.  humidity.  Mean.  Max. 

54°         104°        —9°  72perct.  47.4  inches.        60  inches. 

Average  number  of  cloudy  days,  107.  Fogs  are  very  rare.  Snow 
seldom  remains  on  the  ground  more  than  a  few  hours. 

By  seasons  the  mean  monthly  record  of  temperature  in  Vineland 
for  three  years  (1891-93)  was  as  follows:  winter,  34°;  spring, 
49°;  summer,  73°;  autumn,  55°;  annual,  54°.  The  mean  for 
January  was  30°  and  for  July  74°.  In  1893  the  maximum  tem- 
perature was  102°  and  the  minimum  9°. 

The  region  west  of  Lakewood  and  north  of  Vineland  possesses 
the  natural  advantages  of  a  dry,  porous  soil,  an  environment  of 
pine-forest,  and  easy  accessibility  from  the  great  centres  of  popula- 
tion. The  accommodations  are  better  in  Lakewood  than  elsewhere. 
There  the  hotels  are  large,  with  glass-screened  verandas,  and  are 
noted  for  their  comfort  and  luxury. 


218  MEDICAL  CLIMATOLOGY. 


Pennsylvania. 


The  system  of  mountains  known  as  the  Alleghenies,  extending  in 
several  parallel  ranges  through  Pennsylvania,  Maryland,  and  Vir- 
ginia and  into  North  and  South  Carolina  and  Tennessee,  furnishes 
throughout  its  entire  length  innumerable  summer- and  health-resorts. 

The  Dela^ware  Water  Gap  lies  between  Pennsylvania  and  New 
Jersey.  The  scenery  of  this  mountainous  district  is  wild  and  beauti- 
ful, the  ''  Gap  "  itself  being  a  narrow  gorge  through  which  flows  the 
Delaware  River.  The  walls  of  the  gorge  attain  a  height  of  1600 
feet,  and  are  capped  by  Mounts  Minsi  and  Tammany.  The  Water 
Grap  is  a  famous  and  favorite  resort,  and  affords  many  amusements 
and  occupations,  among  which  are  driving,  shooting,  and  fishing. 

Mauch  Chunk,  lying  in  the  centre  of  the  Pennsylvania  coal- 
region  and  surrounded  by  beautiful  scenery,  is  located  on  a  rocky 
shelf  overhanging  the  Lehigh  River  and  at  the  foot  of  Bear  Mouu- 
tain,  which  rises  to  a  height  of  700  feet  above  the  town.  It  is 
reached  over  the  Reading  Railroad,  and  is  much  resorted  to  in 
summer ;  it  abounds  in  comfortable  hotels.  The  famous  Switch- 
back Railroad,  built  to  bring  coal  from  the  mines,  but  now  used 
only  for  pleasure,  is  the  chief  curiosity  of  this  vicinity. 

Glen  Summit  is  thirty  miles  from  Mauch  Chunk,  lying  on  the 
crest  of  the  mountains  at  an  elevation  of  2000  feet.  It  affords  the 
most  beautiful  views  and  many  charming  walks  and  driv^es.  There 
are  a  number  of  pretty  cottages  and  one  good  hotel,  and  the  place  is 
much  patronized  in  summer. 

Cresson  Springs,  lying  at  the  summit  of  the  Alleghenies,  3020 
feet  above  the  sea,  is  a  popular  summer-resort.  The  scenery  in  this 
neighborhood  is  most  beautiful.  The  summer  climate  at  Cresson  is 
delightful,  for  the  elevation  adds  dryness  to  the  pure  air  and  insures 
a  low  temperature.  Coaches  run  between  Cresson  and  Loretto, 
which  was  founded  by  Prince  Demetrius  Gallitzin,  who  for  forty 
years  worked  as  a  missionary  in  this  vicinity. 

Kane  is  in  the  northern  part  of  Pennsylvania,  on  the  watershed 
which  separates  the  waters  flowing  into  the  Ohio  from  those  which 
empty  into  the  Susquehanna.  This  region  is  drier  than  any  other 
district  of  Pennsylvania.  Kane  has  an  elevation  of  2000  feet. 
The  surrounding  country  is  rough  and  mountainous,  and  the  heights 
are,  for  the  most  part,  well  timbered  to  the  top.  The  soil  is  sandy 
and  absorbent,  the  climate  stimulating,  and  there  are  opportunities 


EASTERN  CLIMATES.  219 

for  pleasant  and  healthful  outdoor  life.  The  population  of  the  town 
is  about  4000,  and  the  chief  industry  is  manufacturing,  Kane  has  an 
excellent  hotel,  which  is  kept  open  throughout  the  year. 

Bag-le's  Mere  is  a  summer-resort  lying  at  an  elevation  of  2060 
feet.  It  has  a  lake,  which  furnishes  opportunity  for  boating  and 
bathing,  and  four  hotels ;  there  are  also  some  cottages  which  may 
be  rented. 

Mount  Pocono.  Three  and  a  half  hours  by  rail  from  New  York 
and  an  hour  longer  from  Philadelphia,  in  Monroe  County,  is  Mount 
Pocono.  This  resort  has  a  stony,  absorbent  soil  and  a  dry,  pure 
air,  and  the  quality  of  the  climate  is  decidedly  tonic.  The  water- 
supply  is  said  to  be  especially  pure.  The  scenery  is  remarkably 
beautiful,  and  there  are  delightful  drives  and  walks  through  the 
surrounding  country.  Dr.  Judd^  says  that  the  temperature  of  the 
plateau  is  ten  or  fifteen  degrees  lower  than  it  is  in  New  York  and 
Philadelphia,  and  there  are  no  mosquitoes.  There  are  good,  plain 
accommodations. 

1  Transactions  of  the  American  Climatological  Association,  1895. 


CHAPTER   XII. 

SOUTHERN  CLIMATES. 

Maryland. 

Deer  Park.  lu  the  extreme  southwestern  part  of  Maryland,  in 
the  heart  of  the  Alleghenies,  lies  Deer  Park,  which  is  reached  by 
the  Baltimore  and  Ohio  Railroad.  Its  elevation  is  2400  feet,  and 
it  is  situated  in  a  region  the  beauty  of  which  is  unsurpassed.  The 
summer-climate  is  delightfully  cool  and  fresh,  and  among  the  diver- 
sions of  the  place  are  charming  walks  and  drives  and  good  boating 
and  fishing. 

Virg-inia. 

The  group  of  thermal  springs  known  as  the  Hot,  Warm,  and 
Healing  Springs  lies  in  a  mountainous  region  at  an  elevation  of 
over  2000  feet.  The  waters  of  the  Hot  Springs  have  a  temperature 
ranging  from  78°  to  180°  F.  The  Warm  Springs  have  a  tempera- 
ture of  98°  and  the  Healing  Springs  of  84°. 

The  Hot  Springs  are  provided  with  the  most  elaborate  modern 
bathing-accommodations  of  every  kind  for  invalids  or  visitors,  which 
compare  favorably  with  those  at  certain  celebrated  spas  in  Europe, 
such  as  Aix-les-Bains ;  the  surrounding  grounds  are  beautifully 
and  attractively  laid  out,  and  the  hotels  are  acceptable  to  the  most 
fastidious.  The  Warm  Springs  and  Healing  Springs  are  each 
within  a  pleasant  drive,  and  the  accommodations  at  these  places  are 
comfortable,  with  a  pleasing,  old-time  air  about  them.  The  climate 
is  moderately  cool  and  fairly  dry,  giving  an  agreeable  change  in  sum- 
mer to  Northern  visitors,  for  whom  this  has  recently  become  a  fash- 
ionable resort. 

West  Virginia. 

West  Virginia  has  several  resorts  where  the  chief  attraction  is 
the  presence  of  mineral  springs.  Among  them  may  be  mentioned 
the  Jordan  Alum  Springs,  in  the  Mill  Mountains  ;  the  Old  Sweet 
Springs,  in  the  midst  of  the  Alleghenies,  where  ample  swimmiug- 
baths  forju  the  chief  feature  ;  and  the  White  Sulphur  Springs,  in 


SOUTHERN  CLIMATES.  221 

Greenbrier  County,  lying  amid  beautiful  mountain-scenery  and  well 
known  for  many  years  as  a  fashionable  resort. 

North  Carolina. 

Asheville  (elevation,  2250  feet;  population,  10,000).  The  town 
of  Asheville  is  situated  on  an  elevated  plateau  one  hundred  and 
seventy-five  miles  long  and  from  ten  to  fifty  miles  wide.  The 
average  elevation  of  this  irregular  plateau  is  2000  feet,  rising  still 
higher  in  the  northern  portion.  On  the  soutii  and  east  are  the 
Blue  Ridge  Mountains,  while  the  Great  Smoky  Mountains  form  the 
northern  and  western  boundary.  This  plateau  is  one  of  the  most 
beautiful  tracts  of  land  in  the  United  States,  and  has  long  been  a 
favorite  summer-resort. 

It  has  a  few  hotels  that  are  open  all  the  year  round.  The  win- 
ters are  said  to  be  fine,  as  snow  seldom  remains  long  in  the  valleys. 
The  soil  is  mostly  red  clay — in  some  places  sandy.  After  rain 
there  is  deep  mud,  but  it  dries  rapidly.  The  mountains  are  covered 
with  a  dense  growth  of  forest.  Ou  the  mountains  the  rainfall  is 
15  to  20  inches,  and  the  relative  humidity  10  or  12  per  cent,  higher 
than  at  Asheville.^  There  are  numerous  streams  of  clear  water. 
Good  water  is  obtained  for  town-supply  from  the  mountains.  The 
hotel-accommodations  are  excellent. 

Sulphur  and  chalybeate  springs  are  found  near  Asheville. 

The  average  number  of  fair  days  is  259.  The  mean  of  annual 
rainfall  is  45.4  iuches.  Taken  from  the  record  for  thirteen  years,^ 
by  seasons  the  rainfall  is  :  winter,  9.3  inches  ;  spring,  11.2  inches; 
summer,  13.7  inches;  autumn,  8.2  inches. 

The  mean  monthly  temperature  for  winter  is  38°;  spring,  53°; 
summer,  71°;  autumn,  53°.  The  mean  annual  relative  humidity 
is  69  per  ceut.^ 

The  principal  seasons  are  in  February  and  March  and  July  and 
August.  Seventy  thousand  persons  are  said  to  visit  Asheville 
annually. 

The  wind-movement  for  Asheville  is  not  obtainable.  As  none  of 
the  peaks  are  within  ten  miles  of  the  town  there  is  room  for  free 
air-circulation.     If  the  winds  are  too  keen  aud  penetrating  during 

1  Asheville  and  its  Climate.    Karl  Von  Ruck,  B.S.,  M.D.,  1891. 

2  Rainfall  and  Snow  of  the  United  States.    Prof.  M.  W.  Harrington,  1894. 

3  Records  of  J.  W.  Gleitsmann,  M.D.,  for  Asheville  temperature  (thirteen  years)  and  humidity 
(four  years),  as  quoted  by  Buck's  Reference  Handbook  of  the  Medical  Sciences. 


222  MEDICAL  CLIMATOLOOY. 

the  winter  and  spring,  a  more  sheltered  country  can  be  found  over 
the  Blue  Ridge  Mountains,  on  the  southern  slopes  of  the  range,  in 
some  of  the  picturesque  northern  counties  of  South  Carolina.  There 
are  no  complete  meteorological  records,  but  as  a  guide  the  following 
records  of  temperature  for  the  year  1891  may  be  compared  :  Ashe- 
ville — January,  37°;  February,  45°.  Spartanburg — January,  42°; 
February,  48°.  Spartanburg  is  790  feet  above  the  sea,  and  has  a 
population  of  5500.  It  is  seventy  miles,  or  three  and  one-quarter 
hours  by  rail,  from  Asheville. 

"Warm  Springs.  Thirty -seven  miles  northwest  from  Asheville 
are  the  Warm  Springs  of  North  Carolina.  There  are  two  springs 
flowing  at  the  temperature  of  97°  and  102°F.  They  are  situated  in 
a  small  and  pretty  open  park,  surrounded  by  mountains  covered 
with  hard  and  pine  timber.  For  accommodation  there  are  one 
good  hotel,  two  boarding-houses,  and  several  cottages.  The  eleva- 
tion of  the  Warm  Springs  is  given  in  Toner's  Dictionary  of  Eleva- 
tions as  1326  feet. 

A  recent  record  of  the  weather  for  six  months — November  to 
April,  inclusive — shows  32  days  cloudy  or  rainy,  and  a  mean  tem- 
perature of  47 °F.,  with  a  relative  humidity  of  71  per  cent. 

Southern  Pines.  There  are  a  small  village  and  a  hotel  at  South- 
ern Pines  Park,^  sixty -eight  miles  southwest  of  Raleigh,  and  near 
the  line  of  the  Raleigh  and  Augusta  Railroad.  The  situation  is 
on  the  summit  of  an  extensive  sandy  elevation  covered  with  pine- 
forests.  The  record  of  temperature  at  Manly,  on  the  railroad,  seven 
miles  to  the  northwest  of  Southern  Pines,  for  one  year  (December, 
1881,  to  November,  1882)  is:  for  winter,  48°;  for  spring,  61°; 
for  summer,  79°;  for  autumn,  62°;  mean  annual  temperature,  62°. 
For  eastern  North  Carolina  the  average  temperature  for  a  series  of 
years  is  stated  to  be  :  for  winter,  46°;  for  summer,  80°;  annual,  69°. 
The  average  annual  rainfall  is  44  inches.  Snowfall  rare  and  light. 
The  soil  is  sandy  and  porous.  Spring-water  can  be  obtained  at  a 
depth  of  forty  feet.  There  is  a  large  hotel  at  Southern  Pines,  and 
at  Pine  Bluff  are  a  number  of  cottages  which  may  be  rented  with  or 
without  board. 

Pinehurst,  situated  six  miles  to  the  west  of  Southern  Pines,  is 
reached  over  the  Seaboard  Air  Line,  or  via  Aberdeen  by  the  Aber- 
deen and  West  End  Railroad,  and  is  said  to  be  a  comfortable  and 

'  Southern  Pines  Park,  a  New  Winter  Health-resort.    A.  N.  Bell,  M.D.   Transactions  of  the 
American  Cliraatological  Association,  1886. 


SOUTHERN  CLIMATES. 


223 


iuexpensive  resort.  The  town  is  furnished  with  a  sewerage-system 
aud  has  a  plentiful  supply  of  pure  water.  Pinehurst  is  connected 
with  Southern  Pines  by  an  electric  tramway.  The  average  summer 
temperature  is  77 °F.,  and  that  of  the  winter  44°,  corresponding  nearly 
to  those  of  Southern  France  and  of  Genoa  and  Florence  ;  and  snow 
is  rare.  The  soil  is  sandy  and  absorbent,  the  situation  sheltered, 
and  the  atmosphere  dry.  There  is  a  good  hotel — the  Holly  Inn — 
which  has  a  glass-enclosed  sun-room,  and  there  are  cottages  and 
apartments  to  let. 

South  Carolina. 

Camden  (population,  3500),  situated  in  the  upper  pine-belt  of 
South  Carolina,  has  been  well  spoken  of  as  a  winter-residence.  It 
is  a  gently  rolling  country,  covered  with  forests  of  long-leafed  pine. 
The  elevation  is  about  200  feet.  There  are  two  hotels.  The  soil 
is  light  and  sandy,  and  the  water  and  drainage  are  said  to  be  good. 
The  coldest  noon-temperature  in  February,  1890,  was  50°F. ;  in 
March,  40°;  in  April,  50°.  The  warmest  noon-temperatures  were 
in  February,  83°;  in  March,  81°;  in  April,  86°.  Mean  winter- 
temperature,  45°;  mean  spring-temperature,  62°.  The  mean  an- 
nual rainfall  is  41 1  inches.  The  greatest  precipitation  is  usually  in 
July  and  August,  the  least  in  October  and  November.  The  aver- 
age monthly  rainfall  for  December  to  May,  inclusive,  is  3j  inches. 
Frosts  occur  at  night  only,  and  snow  is  exceptional. 

Aiken  (elevation,  550  feet ;  population,  2500)  is  situated  in  South 
Carolina  near  the  Georgia  State-line,  on  an  elevated  plateau  between 
the  Savannah  and  Edisto  Rivers,  and  distant  from  the  ocean  a  little 
over  one  hundred  miles.  The  town  lies  on  sandy  soil  and  in  the 
country  of  the  yellow  or  long-leafed  pine,  the  balsamic  odor  of  the 
surrounding  forests  being  very  perceptible.  Grass  grows  scantily, 
but  there  are  beautiful  gardens  in  the  town.  There  is  said  to  be 
no  malaria.  Pure  water  is  procured  from  wells  at  a  depth  of  from 
eighty  to  one  hundred  and  fifty  feet. 

The  mean  annual  temperature  is  61°  F.,  and  by  seasons:  winter, 
47°;  spring,  59°;  summer,  77°;  autumn,  61°.  The  mean  monthly 
temperature  of  January  is  41°  from  records  for  the  three  years 
1 891-98.  The  mean  annual  rainfall  (fo*-  twenty-five  years)  is  48 
ii.ches.^  The  greatest  annual  precipitation  was  65.6  inches  in  1888, 
and  the  least  33.9  inches  in  1860.     Snow  rarely  falls.     There  is 

'  Rainfall  and  Snow  of  the  United  States.    Prof.  M.  W.  Harrington,  1S94. 


224  MEDICAL  CLIMATOLOGY. 

little  clew.      Frosts  are  light,  and   usually  occur  in  January  and 
February. 

Dr.  W.  B.  Geddings,  of  Aiken,  read  a  paper  before  the  meeting 
of  the  American  Climatological  Association  in  1886,  in  which  he 
reported  the  following  meteorological  data  for  Aiken : 

Monthly  means. 


Temp. 

Rel.  humidity 

Rainfall 

Cloudy  days 

(11  years). 

(7  years). 

(11  years). 

(11  years). 

Xovember, 

54° 

62  per  ct. 

3.43  inches. 

11  days. 

December, 

47 

59       " 

3.28 

11     " 

January, 

48 

62       " 

3.64 

11     " 

February, 

50 

56       " 

3.26 

9     " 

March, 

56 

52       " 

4.86 

10     " 

April, 

66 

56       " 

4.71 

7     " 

Winter  : 

December, 

) 

January, 

48 

59       " 

10.18 

<( 

31     " 

February, 

) 

The  greatest  monthly  precipitation  is  in  March  and  April,  but 
the  sandy  soil  of  Aiken  is  porous,  and  it  will  be  seen  that  for  those 
months  there  is  no  increase  of  cloudy  days. 

The  mean  monthly  relative  humidity  for  the  year  1877  was  64 
per  cent.;  for  the  winter  jt  was  65  per  cent.^  The  wind-movement 
in  winter  averages  3.5  miles  per  hour.  The  prevailing  winds  are 
from  the  southwest.    There  are  occasional  high  winds. 

Aiken  is  about  fifteen  miles  from  Augusta,  Georgia,  which  may 
be  described  here,  as  its  meteorological  record  is  more  complete. 

Georgia. 

Augusta  is  an  attractive  city  of  35,000  inhabitants,  situated  on 
the  Savannah  River,  about  four  hundred  feet  lower  than  Aiken^ 
although  no  nearer  the  sea.      It  has  broad,  well-shaded  streets. 

Its  weather-record  for  two  years  is  as  follows: 

Meteorological  Data,  1892-93. 


Mean  monthly 

Relative 

Absolute 

Total 

Wind 

Cloudy 

temperature. 

humidity. 

humidity. 

rainfall. 

per  hour. 

days. 

Winter, 

47° 

75  per  ct. 

2.56  gr. 

11.80  in. 

6  miles. 

32 

Spring, 

63 

66       " 

3.95  " 

7.92    " 

6       " 

20 

Summer, 

79 

78       " 

7.74  " 

15.41    " 

4       " 

22 

Autumn, 

63 

76 

4.38  " 

8.95   " 

4.9    " 

16 

Year, 

63 

74       " 

4.38  " 

44.09    " 

5.3    " 

91 

'  Aiken  as  a  Health-station.    W.  H.  Geddings,  M.D.    Charleston,  1S77. 


SOUTHERN  CLIMATES.  225 

The  annual  means  for  Augusta  (for  ten  years)  are  as  follows: 
temperature,  64°  F.;  relative  humidity,  74  per  cent.;  absolute 
humidity,  4.54  grains;  rainfall,  45^  inches;  number  of  cloudy 
days,  99;  average  wind-movement,  3.8  miles  per  hour. 

Summerville.  Many  visitors  and  invalids  resort  in  the  winter 
season  to  the  Bon  Air  Hotel  at  this  point,  which  is  well  known  for 
its  pleasant  features. 

Thomasville  (elevation,  330  feet ;  population,  5500)  is  situated 
in  the  pine-woods  in  the  extreme  southern  part  of  Georgia,  near  the 
Florida-line.  It  is  about  one  hundred  and  sixty  miles  from  the 
Atlantic  Ocean  and  sixty  miles  from  the  Gulf  of  Mexico.  The  soil 
is  sandy.  Water  is  obtained  from  artesian  wells,  one  well  having  a 
depth  of  1900  feet.  There  are  several  good  hotels  and  boarding- 
houses. 

The  annual  precipitation  is  51^  inches.  The  greatest  amount  of 
rainfall  is  in  the  spring.  There  are  97  cloudy  days  during  the 
year.  The  mean  annual  temperature  is  68°  F. ;  relative  humidity, 
65  per  cent.;  absolute  humidity,  4.56  grains  of  vapor  per  cubic  foot ; 
wind-movement,  5.7  miles  per  hour.  For  winter  Thomasville  has 
50°  of  temperature ;  67  per  cent,  of  relative  humidity  ;^  4.6  grains 
of  absolute  humidity;  and  11.71  inches  of  rainfall.  The  wind- 
movement  in  winter  is  low.  The  prevailing  winds  are  south  and 
northwest. 

Florida. 

The  peninsula  of  Florida,  bounded  on  the  north  by  the  States  of 
Georgia  and  Alabama,  projects  southward  with  a  slight  inclination 
to  the  east,  and  separates  the  Atlantic  from  the  Gulf  of  Mexico. 
Its  length  is  about  three  hundred  miles,  and  its  width  averages 
over  one  hundred. 

As  set  forth  in  the  valuable  article  by  the  late  Dr.  J.  M. 
Keating,^  Florida  may  be  divided  by  two  methods  and  into  two 
parts.  The  first,  or  geographical,  division  is  into  north  aiid  south 
Florida,  and  is  determined  by  the  twenty-ninth  parallel  of  north 
latitude.  The  second,  or  topographical,  division  is  into  the  low- 
lands which  border  the  rivers  and  coasts  and  the  higher  tracts 
found  inland. 

1  Buck's  Reference  Handbook  of  the  Medical  Sciences  quotes  temperature-  and  humidity- 
records  for  six  years. 
-  Transactions  of  the  American  Climatological  Association,  1885. 

15 


226         ■  MEDICAL  CLIMATOLOGY. 

The  climate  of  the  peninsula  below  the  twenty-ninth  parallel  is 
very  different,  in  both  summer  and  winter,  from  that  of  the  country 
immediately  north  of  it.  During  the  summer  there  is  more  breeze 
and  the  nights  are  usually  cool.  In  winter,  besides  the  fact  that  the 
climate  of  the  southern  portion  of  the  State  is,  of  course,  milder, 
there  remains  the  consideration  that  the  cold  winds  which  blow 
from  the  northwest  reach  here  only  after  crossing  the  warm  waters 
of  the  Gulf  and  receiving  their  tempering  influence,  and,  as  a  con- 
sequence of  this,  the  temperature,  which  may  drop  rather  suddenly 
in  the  northern  part  of  Florida,  changes  much  more  gradually  in  the 
southern  part. 

The  land  is  mostly  low  and  flat,  though  there  is  a  ridge  extending 
about  halfway  down  and  ranging  from  one  hundred  to  three  hun- 
dred feet  in  height,  upon  which  pines  grow. 

Florida  is  studded  with  lakes  and  traversed  by  numerous  streams 
and  salt-water  channels. 

The  soil  is  very  porous,  and  is  for  the  most  part  sand  over  a  clay 
subsoil.     Semitropical  fruits  grow  freely. 

The  climate,  as  follows  from  its  geographical  position,  is  marine 
in  character,  and,  though  situated  in  the  same  latitude  as  Northern 
Hindustan,  Southern  China,  and  the  Desert  of  Sahara,  it  is  far  more 
equable  and  temperate. 

The  mean  annual  temperature  varies  from  69°  F.  at  Sanford  to 
79.8°  at  Jacksonville ;  for  the  winter  the  variation  is  from  54.6°  at 
Pensacola  to  66.5°  at  Jupiter.  The  range,  for  winter,  averages  be- 
tween 14°  and  20°.      Frost,  snow,  and  ice  are  very  rare. 

The  mean  annual  rainfall  varies  from  53.19  inches  at  Pensacola  to 
57.16  inches  at  Cedar  Keys.  Of  this  about  one-half  usually  occurs 
in  the  summer. 

The  mean  relative  humidity  for  the  year  varies  from  76  per  cent, 
at  Pensacola  to  80  per  cent,  at  Cedar  Keys.  In  the  winter  months 
it  is  from  76  per  cent,  to  87  per  cent. 

Of  the  absolute  humidity  Dr.  J.  P.  Wall,  of  Tampa,  speaks  as 
follows:  "The  amount  of  absolute  humidity  for  summer  is  about 
twice  what  it  is  in  the  winter,  dependent,  of  course,  upon  the  higher 
temperature  of  the  summer.  According  to  General  Greely's  esti- 
mate of  absolute  humidity  based  on  ten  years  of  observation,  1876- 
1886,  the  absolute  humidity  for  the  month  of  January  is,  for  the 
northern  part  of  the  State,  3  grains  of  water  to  the  cubic  foot  of 
air;  for  the  base  or  neck  of  the  peninsula,  4  grains  of  water  to  the 


SOUTHERN  CLIMATES.  227 

cubic  foot;  alonff  the  twenty-eighth  parallel  of  latitude  from  the 
Atlantic  to  Tampa  Bay  on  the  Gulf,  5  grains  of  water  to  the  cubic 
foot;  and  for  the  extreme  poiut  of  the  peninsula  and  Key  West,  6 
grains  of  water  to  the  cubic  foot.  The  amount  of  absolute  humidity 
for  the  month  of  July  is  9  grains  of  water  to  the  cubic  foot  for  the 
entire  State. 

^'  Of  course,  as  might  naturally  be  expected  of  a  climate  with  the 
temperature  and  humidity  of  that  of  Florida,  heavy  dews  on  clear, 
still  nights  are  always  present,  and  during  the  winter  and  spring 
fogs  in  the  nights  and  early  mornings  are  not  uncommon.  Fogs 
are,  however,  somewhat  worse  on  the  Atlantic  coast  and  on  the  St. 
John's  River  than  on  the  Gulf  side  of  the  peninsula."^ 

The  average  hourly  velocity  of  the  wind  (for  1887)  varied  from 
7.4  miles  at  Pensacola  to  9.4  miles  at  Cedar  Keys. 

The  total  number  of  rainy  days  for  the  year  1887  ranged  from 
103.8  at  Cedar  Keys  to  124.1  at  Pensacola,  and  the  number  of 
cloudy  days  for  the  same  year  and  the  same  places  was  66.8  and 
84.5. 

Dr.  Wall,  while  admitting  the  prevalence  of  malaria,  states  that 
there  are  many  places  entirely  free  from  it,  and  that  it  is  generally 
diminishing. 

Dr.  Keating  expresses  the  opinion  that  southern  Florida  is  better 
adapted  for  invalids  than  the  northern  section  of  the  State.  He 
was  not  favorably  impressed  with  the  resorts  upon  the  St.  John's 
River  for  health-purposes,  and  speaks  of  the  interior  lake-district 
around  Winter  Park  and  Orlando  as  best  adapted  for  chest-cases. 
Dr.  J.  C.  Wilson  also  writes  of  this  country:  "■  It  is  safe  to  predict 
for  this  region  a  useful  future  in  the  climate-treatment  of  diseases 
of  the  chest.  "2 

Florida  was  formerly  much  used  as  a  winter-resort  for  consump- 
tives, but  of  late  years  physicians  have  recognized  the  fact  that  in 
the  enervating  air  of  this  beautiful  peninsula  there  is  great  danger 
of  increasing  the  ansemia  usually  found  in  phthisical  invalids;  dan- 
ger also  to  them  through  the  fact  that  their  depressed  vitality  ren- 
ders them  peculiarly  susceptible  to  the  insidious  malarial  influences 
which  are  present  at  so  many  of  the  Florida  resorts  at  certain  seasons 
of  the  year. 

For  elderly  people,  well-nourished  persons  with  irritable  catarrhs, 

1  The  Climate  of  Florida.    Pr.  J.  P.  Wall,  in  the  Climatologist  for  November,  1891. 
-  Transactions  of  the  American  Climatological  Association,  1885. 


228  MEDICAL  CLIMATOLOGY. 

and  certain  valetudinarians  and  convalescents,  Florida  is  well 
suited,  and  for  them  it  presents  peculiar  attractions. 

It  is  easily  accessible  from  the  Eastern  and  Southern  States, 
and  has  accommodations  suited  to  the  millionaire  or  to  the  health- 
seeker  of  moderate  means.  The  weary  may  rest  out  of  doors  in  the 
temperate  and  sunny  air,  and  the  invalid  who  is  able  to  live  a  more 
active  life  may  seek  diversion  in  hunting,  fishing,  and  boating,  for 
which  the  extensive  coast-line  and  the  numerous  lakes,  rivers,  and 
forests  offer  exceptional  opportunities. 

Jacksonville,  on  the  left  side  of  the  St.  John's  River  and 
twenty-two  miles  from  its  mouth,  is  a  city  of  nearly  8000  inhab- 
itants. It  is  a  busy  town,  well  provided  with  hotels  and  tram- 
ways. The  shell-roads  are  good,  and  many  charming  drives  may 
be  taken  through  this  vicinity.  The  town  is  a  much-frequented 
resort.  The  winter  climate  is  medium  moist,  mild,  and  equable. 
The  mean  winter-temperature  is  55°  F. 

Palatka,  situated  south  of  Jacksonville,  on  the  St.  John's  River, 
is  a  very  pleasant  town  of  about  3000  inhabitants.  It  is  a  gather- 
ing-point for  many  Northern  visitors.  The  smaller  steamers  which 
make  the  trip  up  the  Ocklawaha  River  start  from  here.  Palatka 
possesses  good  hotels. 

"Winter  Park,  one  hundred  and  twenty  miles  south  of  Jackson- 
ville and  sixty-five  miles  north  of  Tampa,  is  situated  in  the  narrow 
part  of  the  peninsula  of  Florida,  about  forty  miles  from  the  Atlantic 
coast.  It  is  reached  direct  by  rail  from  Philadelphia,  New  York, 
and  Washington,  and  is  thus  easily  accessible.  It  oifers  good  edu- 
cational facilities  and  possesses  a  pleasant  society. 

Dr.  Eager,^  of  Winter  Park,  says  that  there  are  good  sanitary 
arrangements  and  a  pure  and  abundant  water-supply,  and  that  there 
is  no  malaria.  The  site  and  surroundings  of  the  town  are  the  high 
pine-lands  of  the  peninsula.  From  April  1st  to  June  1st  very  little 
rain  falls,  and  during  these  months  the  temperature  from  4  p.m.  to 
9  A.M.  ranges  from  65°  to  72°  F.,  and  from  72°  to  85°  for  the 
remaining  hours.  The  average  temperature  of  the  winter-day  is 
60°  to  65°  for  the  twenty-four  hours.     Frost  is  very  rare. 

A  large  hotel,  the  ^'Seminole,"  offers  first-class  accommodations 
to  visitors. 

Orlando,  a  town  of  2500  inhabitants,  lies  one  hundred  feet  above 

1  The  Climatologist  for  July,  1S92. 


SOUTHERN  CLUIATES.  229 

the  St.  John's  River,  iu  an  undulating,  often  liilly  country.  It  is 
surrounded  by  pine-forests,  and  is  said  to  be  entirely  free  from 
malaria.      The  soil  is  very  absorbent. 

Altamonte,  a  few  miles  from  Orlando  and  situated  iu  the  pine- 
forests,  has  a  good  hotel  with  an  excellent  cuisine.  The  soil  is  sandy 
and  readily  absorbs  moisture. 

In  Orange  County,  near  the  Ocklawaha  Lakes,  arc  a  number  of 
towns — Eustis,  Taverse,  Leesburg-,  Mount  Dora — situated  in  a 
rolling  country  which  is  well  suited  for  health-seekers. 

Tampa,  on  Hillsborough  Bay,  a  branch  of  Tampa  Bay,  and  at 
the  mouth  of  the  Hillsborough  River,  is  a  town  of  over  5000  in- 
habitants. This  part  of  the  country  affords  good  sport,  as  the  waters 
abound  in  fish,  and  inland  are  deer  and  other  game.  Tampa  is  a 
favorite  resort,  and  has  become  more  so  since  the  establishment  of 
the  Tampa  Bay  Hotel,  which  is  a  magnificent  building  provided 
with  every  possible  luxury  and  convenience.  There  are  also  other 
hotels  and  fine  villas.  The  neighborhood  is  interesting,  and  various 
pleasant  excursions  may  be  taken.  At  Indian  Hill,  not  far  distant, 
are  the  singular  shell-mounds  in  which  were  found  human  remains. 

Los*  Pinellas  is  a  small  peninsula  runuing  southwest  between 
Tampa  Bay  and  the  Gulf  of  Mexico.  Its  climate  has  been  com- 
pared with  that  of  the  peninsula  of  Coronado.  It  is  recommended 
by  Dr.  J.  C.  Wilson,  of  Philadelphia,  for  its  climate  and  attractive- 
ness. The  climate  is  colder  than  that  of  places  in  the  same  latitude 
on  the  Indian  River.  The  mean  temperature  is  72°  F.;  mean  win- 
ter-temperature, 62°;  mean  summer-temperature,  80°.  The  relative 
humidity  is  85  per  cent.      The  soil  is  sandy  and  porous. 

The  Lake  "Worth  district  is  much  resorted  to  by  visitors  who 
desire  to  escape  the  inclemency  of  Northern  winters.  The  lake 
is  twenty-two  miles  in  length  and  varies  in  width  from  one-half  a 
mile  to  one  mile.  Its  waters  abound  in  fish,  among  others  the  much- 
talked-of  tarpou.  The  vegetation  includes  the  cocoanut-palm. 
Many  handsome  villas  have  be3n  built  at  different  points  along 
the  shore.  The  hotels  are  first-class,  and  include  the  handsome 
Lake  Worth  Hotel  and  that  at  Palm  Beach. 

Gulf  Coast  from  Pensacola  to  Galveston. 

Along;  the  Gulf  coast  westward  from  Pensacola  to  New  Orleans 
and  on  to  Galveston  are  many  shore-resorts  where  the  winters  are 
mild  and  the  summers  cooler  than  the  neighboring  inland.     These 


230  MEDICAL  CLIMATOLOGY. 

are  much  used  by  the  inhabitants  of  the  Gulf  States.  Perhaps  the 
most  agreeable  of  such  resorts  are  found  where  the  bay  curves  from 
Mobile  southwest  to  New  Orleans.  The  best  known  and  the  most 
frequented  in  winter  by  Northern  visitors  is  Pass  Christian.  No 
meteorological  tables  are  obtainable,  and  the  information  given 
below  was  obtained  from  a  local  physician  and  from  statements 
of  visiting  patients. 

Pass  Christian  lies  on  the  coast  of  the  Gulf  of  Mexico,  in  the 
centre  of  the  curve  between  Mobile  and  New  Orleans.  It  is  eighty- 
four  miles  from  Mobile  and  fifty-eight  miles  from  New  Orleans  via 
the  Louisville  and  Nashville  Railroad.  The  population  is  about 
3000.  It  has  a  large,  well-kept  hotel,  several  boarding-houses, 
and  cottages  for  rent.  In  the  winter-season,  from  November  to 
May,  it  is  much  frequented  by  invalids  and  visitors  from  the  North, 
and  in  summer  by  the  residents  of  neighboring  cities. 

Dr.  C.  L.  IjC  Eoux,  of  Pass  Christian,  writes  of  its  situation  : 
''At  a  distance  from  shore  varying  from  five  to  eight  miles  a 
belt  of  islands  forms  a  protective  bulwark  against  the  occasional 
storms  that  may  prevail  in  the  Gulf,  making  the  body  of  water 
between  the  islands  and  the  main  shore  a  sort  of  inland  lake,  ellip- 
tical in  shape  and  rarely  disturbed  beyond  a  ripple.  Immediately 
behind  the  town  .  .  .  lies  a  pine-forest  which  extends  hundreds  of 
miles  in  depth."  The  average  mean  temperature  in  summer  is  given 
at  85"  F. ,  and  in  winter  at  70°.  The  range  is  said  to  be  small,  and 
the  rains  neither  frequent  nor  protracted.  An  occasional  "  norther" 
is  experienced.  There  is  an  average  of  six  pleasant  days  a  week. 
The  soil  is  well  drained,  porous,  and  dry.  There  is  no  malaria, 
and  there  are  pure  artesian-well  water  and  a  good  sewerage-system. 
Roses  bloom  in  profusion  throughout  the  winter.  There  is  a  shell- 
drive  for  fiv^e  miles  along  the  coast,  and  good  boating,  fishing,  and 
shooting  are  among  the  attractions. 

Tennessee. 

Chattanooga  (elevation,  700  feet ;  population,  30,000),  in  the 
southeastern  part  of  Tennessee,  on  the  Tennessee  River,  is  reached 
over  the  East  Tennessee,  Virginia,  and  Georgia  Railroad,  connect- 
ing with  the  Norfolk  and  Western  and  the  Baltimore  and  Ohio 
lines.  It  is  surrounded  by  beautiful  and  varied  scenery,  and  the 
atmosphere  is  pure,  stimulating,  and  bracing.  The  soil  of  this 
region  is  dry  and  loamy,  and  the  drainage  good.      Maximum  daily 


SOUTHERN  CLIMATES.  231 

temperature,  101  °  F.;  minimum,  7°  below  zero.  The  relative  average 
annual  humidity  is  71  per  cent.  The  average  number  of  clear  days 
per  year  is  11 7,  and  of  fair  days  147.  Owing  to  the  sheltered  situa- 
tion of  the  city  fogs  and  winds  are  seldom  experienced,  and  extreme 
sudden  changes  of  temperature  are  rare.  The  roads  in  the  neigh- 
borhood are  good,  and  driving  and  wheeling  are  popular  amuse- 
ments. Chattanooga  has  excellent  accommodations  as  regards  both 
hotels  and  boarding-houses.  Lookout  Inn,  located  on  Lookout 
Mountain,  is  open  all  the  year.  The  vicinity  is  historically  very 
interesting,  having  been  the  scene  of  the  famous  battles  of  Lookout 
Mountain,  Orchard  Knob,  and  Missionary  Hidge,  so  ably  described 
by  Benjamin  Taylor  in  his  Three  November  Days. 

Arkansas. 

Hot  Springs  (elevation,  425  feet;  population,  10,000)  is  situated 
in  a  narrow  valley  or  ravine  in  the  heart  of  the  Ozark  Mountains. 
It  has  become  one  of  the  most  frequented  resorts  in  the  United 
States,  the  great  attraction  being  the  springs,  numbering  about 
seventy,  the  waters  of  which  have  a  temperature  ranging  from  76° 
to  158°  F.  The  land  on  which  they  rise  is  the  property  of  the 
Government,  which  has  erected  a  hospital  for  officers,  soldiers,  and 
sailors.  These  springs  discharge  about  500,000  gallons  of  water 
daily.  The  amount  of  solids  is  very  small.  The  town  has  good 
hotels  and  shops  and  handsome  bath-houses. 

The  Eureka  Springs  in  Arkansas  are  also  well  known, 

Texas. 

El  Paso  (elevation,  3700  feet;  population,  10,000).  The  old 
Mexican  town  of  El  Paso  is  situated  on  the  banks  of  the  Rio 
Grande,  at  the  foot  of  the  Rocky  Mountains,  in  the  extreme 
western  portion  of  the  State  of  Texas,  where  it  narrows  to  a  point 
between  Mexico  and  the  Territory  of  New  Mexico.  Climatically, 
this  district  belongs  to  the  latter  more  than  to  its  own  State.  It  is 
blessed  with  cloudless  skies  and  is  beyond  the  '' northern"  belt  of 
Texas,  and  consequently  less  liable  to  high  winds,  although,  as  the 
valley  is  not  very  wide,  the  full  force  of  the  wind  is  felt  as  it  sweeps 
through.  There  is  least  wind  during  the  winter  months,  when  it 
averages  5.3  miles  per  hour.  In  the  three  mouths  of  spring  it 
averages  6.6  miles,  and  for  the  year  5.5  miles  per  hour.  There 
are,  however,  occasional  severe  wind-  and  dust-storms.     The  Gos'- 


232  MEDICAL  CLIMATOLOGY. 

ernment  record  for  the  year  1892  shows  the  number  of  days  with 
gales  (wind  40  miles  per  hour  or  over)  to  have  been  15  for  El 
Paso,  as  against  3  at  Santa  Fe  and  3  at  Denver. 

The  principal  rainfall  is  in  July  and  August,  about  40  per  cent, 
of  the  year's  supply  falling  during  those  two  months.  Mean  of 
annual  precipitation,  9  inches. 

Temperature  for  January,  44°  F.;  July,  83°;  for  the  year,  64° 
(means  for  twelve  years).  Average  number  of  days  above  90°,  94  ; 
below  32°,  47.  Cloudy  days,  39;  stormy,  37  (means  for  six  years). 
The  mean  minimum  temperature  for  three  years  (1891-'92-'93)  in 
July  was  70°,  indicating  hot  nights. 

Fair  accomnaodations  can  be  secured.  There  is  one  tolerable  hotel, 
^*  The  Vendome,"  and  comfortable  lodgings  can  be  found  in  the 
town,  while  good  meals  can  be  obtained  at  a  Chinese  restaurant. 

The  soil  is  sandy  in  places,  but  adobe  near  the  river,  and  the 
water  is  bad  unless  from  artesian  wells. 

The  river  bottom-lands  should,  of  course,  be  avoided.  Across 
the  river  in  Mexico  is  the  town  of  Juarez,  where  Mexican  customs 
prevail.  There  is  some  dirt  and  squalor,  but  a  visit  is  usually  con- 
sidered interesting. 

El  Paso  has  limited  resources  for  the  entertainment  of  visitors. 
It  has  a  fine  winter-climate,  but  after  April  the  midday  temperature 
becomes  too  high  foi'  comfort. 

Port  Bliss,  a  military-post,  is  about  five  miles  northeast  of  El 
Paso.  The  present  Fort  Bliss  is  in  a  better  location  than  the  old 
post,  which  was  one  mile  from  the  town. 

San  Antonio  (elevation,  650  feet ;  population,  40,000).  San 
Antonio  is  situated  in  latitude  29°  27'  north,  about  one  hundred 
and  thirty  miles  inland  from  the  Gulf  of  Mexico.  There  are  no 
mountains  to  obstruct  the  prevailing  winds  from  tbe  southeast  and 
east,  and  the  town  is  not,  probably,  entirely  beyond  the  climatic 
influence  of  the  Gulf,  as  the  cooling  effect  of  the  '^  sea-breeze"  may 
indicate.  As  a  health-resort  it  is  available  only  during  the  mouths 
of  winter  and  early  spring.  It  is  a  picturesque  and  interesting 
town,  containing  many  reminders  of  the  early  mission-days.  Many 
of  the  old  churches  and  Spanish-looking  public  buildings  are  in 
an  excellent  state  of  preservation,  and  Spanish  names  are  commonly 
used.      In  the  suburbs  are  several  picturesque  old  missions. 

San  Antonio  is  on  the  edge  of  what  was  formerly  a  great  cattle- 
raising  country.     It  can  be  reached  by  three  lines  of  railroads. 


SOUTHERN  CLIMATES.  233 

Two  small  rivers — the  San  Antonio  and  San  Pedro — flow  through 
the  towu.  The  San  Antonio  River  is  a  dirty  stream  about  sixty 
feet  wide  and  spanned  by  numerous  bridges.  Formerly  a  highly 
objectionable  method  of  draining  into  these  winding  rivers  was 
practised.  In  1895  an  improved  system  of  town-sewerage  was  put 
into  operation  ;  but  a  medical  writer  recently  stated  that  of  8000 
houses  but  400  were  connected  with  sewers.  There  are  three  plazas 
or  public  squares,  street-cars  run  by  electricity,  a  social  clul),  six 
hotels,  and  a  number  of  boarding-houses  and  restaurants. 

The  accommodations  for  invalids  are  inferior.  For  housekeeping 
a  location  on  the  outskirts  of  the  town  should  be  selected. 

The  town  is  supplied  with  pure  but  hard  water  from  springs  at 
the  head  of  the  San  Antonio  River.  Artesian  wells  have  been  drilled 
in  the  town,  which  vary  greatly  in  the  character  of  the  water  they 
yield.  Many  of  them  furnish  good,  soft  water.  There  are  also 
wells  flowing  hot  sulphur  water  of  marked  qualities. 

The  soil  is  adobe. 

The  mean  temperature  of  San  Antonio  for  January  is  51°  F.; 
for  July,  84°;  for  the  year,  69°  (means  for  thirteen  years). 

The  record  of  rainfall  for  twenty-one  years  gives  a  yearly  mean 
of  30.6  inches,  of  which  6.7  inches  usually  fall  during  the  three 
winter  months,  and  7.8  inches  in  the  spring. 

The  air  is  moist,  the  absolute  humidity  even  exceeding  that  of 
San  Diego. 

The  annual  wind-movement  is  not  high,  being  a  little  more  than 
that  of  Denver — about  7  miles  per  hour.  San  Antonio  is  not 
exempt  from  ^'northers,"  but  they  are  infrequent  and  are  much 
modified  compared  with  those  felt  in  the  upper  portion  of  the  State. 
They  rarely  last  over  forty-eight  hours. 

The  average  number  of  cloudy  days  during  the  year  is  92;  of 
stormy  days,  82.  Number  of  days  above  90°,  90;  days  below  32°, 
12  (means  for  six  years). 

The  winters  are  mild  in  San  Antonio.  Roses  usually  bloom  until 
Christmas,  and  sometimes  later,  and  in  February  they  begin  again 
to  bloom  outdoors. 

The  summers  in  San  Antonio  are  hot.  In  1893  there  were  124 
days  on  which  the  temperature  rose  over  90°  F.  Of  these,  85  days 
were  in  July,  August,  and  September  (out  of  a  total  of  92  days), 
the  temperature  being  over  90°  every  day  in  July.     The  maximum 


234  MEDICAL  CLIMATOLOGY. 

temperature  for  the  year  was  103°.  The  mean  rainiraura,  or  night, 
temperature  for  three  years  (1891-'92-'93)  for  July  was  73°. 

(See  Table  XL,  '^Night-temperatures.") 

Boerne'  (elevation,  1670  feet;  population,  800).  The  towu  of 
Boerne  is  situated  on  the  River  Cibolo,  about  thirty  miles  north- 
west of  San  Antonio,  on  the  road  to  Kerrv^ille  (San  Antonio  and 
Aransas  Pass  Railroad  ;  time,  one  and  one-half  hours). 

The  soil  is  mostly  sandy  loam,  with  a  gravelly  subsoil.  The  coun- 
try is  hilly.  Except  for  narrow  borders  of  timber  along  the  streams 
and  a  few  tracts  of  post-oak  and  forests  of  cedar,  the  principal  growth 
is  brush  and  mesquite. 

In  a  description  of  the  town  prepared  by  a  local  physician-  it  is 
stated  that  the  water-supply  is  chiefly  from  wells  of  an  average  depth 
of  thirty-  five  feet.  This  water  is  considered  "  fairly  good."  Water 
from  cisterns  is  also  much  used.  There  are  said  to  be  88  cloudy 
days  during  the  year.  The  wind  is  moderate,  coming  usually  from 
the  south  or  southeast. 

There  are  two  or  three  medium-sized  hotels  and  a  few  boarding- 
houses  in  Boerne.  Boarders  are  always  received  at  a  number  of 
ranch-houses  a  few  miles  from  town. 

The  drives  are  good.  There  are  several  waterfalls  and  other 
objects  of  interest  in  the  vicinity. 

Three  and  one-half  miles  from  Boerne,  on  the  Hughes  ranch,  are 
the  Indian  Mineral  Springs.  The  following  analysis  was  made  by 
C.  F.  Chandler,  Ph.D.,  of  New  York  : 


Chlorine  in  chlorides 
Equivalent  to  sodium  chloride 
Oxides  of  iron  and  aluminum 

Lime 

Magnesia         .... 
Sulphuric  acid  (SO3)  in  sulphates 

Silica 

Solids  by  evaporation 


lu  one  U.  S.  gallon. 
0.512  grain. 
0.844      " 
0.093       " 
45.832  grains. 
6.435       " 
67.246       " 
0.355  grain. 
138.388  grains. 


Dr.  I.  M.  Cline,  who  has  charge  of  the  Texas  weather  service,  has 
written  of  the  country  in  which  Boerue  lies  as  follows  :  '^  Between 
latitude  29°  45'  and  30°  and  to  the  lOOth  meridian  on  the  west  the 
elevation  changes  rapidly  from  1000  to  2000  feet,  with  considerable 
irregularity,  and  is  broken  with  deep  ravines  and  small  creeks,  and 

1  Pronounced  Ber'-ney.    The  towu  was  settled  by  Germans  thirty  or  forty  years  ago. 
=  Boerne  and  Adjacent  Country.    William  Miller,  M.D. 


SOUTHERN  CLIMATES.  235 

along  the  western  border,  as  the  2000-foot  line  of  elevation  is  reached, 
it  is  much  sculptured  by  erosion.  The  soil  between  these  elevations 
is  very  irregular  in  its  formation,  but  is  to  a  great  extent  of  the 
black,  stiff  soil  over  the  eastern  portion,  and  then  blends  toward  the 
west  with  black  and  red  sandy  and  red  loam,  witii  a  pebbly  soil  in 
some  parts;  it  is  also  crossed  here  and  there  by  strips  of  white, 
sandy  land,  with  a  growth  of  scrub  post-oak."^ 

The  monthly  mean  temperature  for  eight  years,  arranged  by  sea- 
sons, is  as  follows  :  winter,  50°;  spring,  69°;  summer,  79°;  autumn, 
65°.     Mean  for  January,  49°;  for  July,  81^;  for  the  year,  65°. 

The  total  seasonal  rainfall  based  on  nine  years'  records  is:  winter, 
5.9  inches;  spring,  9.6  inches;  summer,  6.4  inches;  autumn,  4.9 
inches  ;  annual  mean,  27  inches. 

The  mean  relative  humidity  is  said  to  be  from  QQ  to  72  per  cent." 

Galveston  (latitude,  29°  18'  north;  population,  35,000)  is  situ- 
ated on  the  northwesterly  end  of  tbe  island  of  the  same  name,  four 
miles  from  the  mainland.  The  harbor  is  the  finest  on  the  coast  of 
Texas,  and  the  depth  of  water  over  the  bar  has  been  greatly 
increased  in  recent  years  by  means  of  jetties. 

The  island  is  thirty  miles  long  by  an  average  width  of  three  miles. 
It  is  level,  with  sandy  soil. 

Galveston  is  an  attractive  and  healthy  city,  with  wide,  straight 
streets,  ranging  from  six  and  a  half  to  ten  feet  above  ordinary  tide- 
level.  There  are  several  parks  and  squares.  Many  of  the  streets 
are  shaded  with  oleanders. 

The  climate  of  Galveston  is  warm,  mild,  and  humid.  Occasion- 
ally there  are  winters  when  the  temperature  does  not  fall  below  32°. 
During  the  past  twenty  years  there  have  been  thirteen  years  in 
which  the  temperature  has  not  fallen  below  24°,  and  but  two  years 
below  20°.  The  seasonal  mean-temperature,  from  the  Government 
records  for  eighteen  years,  is  as  follows:  winter,  55°;  spring,  69°; 
summer,  83°;  autumn,  71°.  The  annual  mean  is  70°.  Monthly 
mean  for  January,  53°;  for  July,  84^.  The  extreme  maximum 
temperature-record  is  98°,  and  the   minimum  20°. 

The  mean  of  the  annual  rainfall  for  twenty  years  is  51  inches, 
distributed  as  follows:  winter,  11.5  inches;  spring,  10.2  inches; 
summer,  13.3  inches;  autumn,  16.6  inches.     The  greatest  precipi- 

1  The  Climate  of  Texas.    I.  M.  Cliue,  M.A.,  M.D.,  Galveston,  1894. 

-  Report  of  the  Committee  on  Health-resorts.    Transactions  of  the  American  Climatological 
Association,  1895. 


236  MEDICAL  CLIMATOLOGY. 

tatiou  is  in  September  and  the  least  in  February  and  July.  The 
annual  mean  of  cloudy  days  is  92,  of  stormy  days  108. 

The  mean  annual  relative  humidity  is  77  per  cent. ;  for  winter  it 
is  81  per  cent.  The  wind-movement  averages  for  the  year  11.1 
miles  and  for  the  winter  11.7  miles  per  hour.  The  prevailing  wind 
is  from  the  south  and  southeast.  The  highest  winds  occur  during 
the  winter,  and  blow  from  the  north,  but  the  average  '^northers" 
of  Upper  Texas  are  but  little  felt  on  the  west  coast  of  the  Gulf  of 
Mexico.  ^ 

Galveston  is  rendered  accessible  by  railroads  from  the  north  and 
west,  and  by  steamers  from  New  York  and  one  or  two  European 
ports. 

There  are  good  hotels  and  boarding-houses.  On  the  eastern  shore 
of  the  island  is  a  fine  beach  for  driving  and  surf -bathing. 

Galveston  is  supplied  with  pure,  soft  water  obtained  from  arte- 
sian wells  and  brought  twenty-five  miles  through  thirty-inch  pipes. 

The  natural  drainage  is  aided  by  a  slight  incline  from  the  centre 
of  the  island  toward  the  bay  and  the  gulf.  Sewers  empty  into  both 
bay  and  gulf. 

1  Notes  on  the  Climate  and  Health  of  Galveston.    I.  M.  Cline,  M.A.,  M.D.,  Galveston,  1894. 


CHAPTEE    XIII. 

ROCKY  MOUNTAIN   REGION. 
Monthly  Rainfall  of  the  Southwest. 

Before  proceeding  to  the  study  of  the  climates  of  Colorado,  Utah, 
New  Mexico,  Arizona,  and  Southern  California  it  is  thought  best  to 
present  a  general  view  of  the  monthly  rainfall  over  these  regions.^ 

January.  This  is  a  veri/  wef  mouth  over  all  California  except 
the  southeastern  portion,  where  it  is  wet.  Over  Colorado  (except 
the  eastern  half,  where  it  is  very  dry),  New  Mexico,  and  Arizona 
the  amount  of  precipitation  is  either  about  the  proportional  amount 
with  reference  to  annual  rainfall,  or  deviates  slightly  therefrom. 
The  normal  rainfall-records  for  the  principal  cities  are  as  follows 
for  January  :  Denver,  0.6  ;  Colorado  Springs,  0.2;  Santa  Fe,  0.6  ; 
El  Paso,  0.4;  Prescott,  1.4  ;  Tucson,  0.8;  Salt  Lake  City,  1.6  ;  Los 
Angeles,  3.9  ;  San  Diego,  1.6  inches. 

February.  This  month  is  wet  over  California  (except  the  south- 
western part  of  the  State,  wiiere  it  is  very  wet).  It  is  dry  over  the 
Dakotas  southward  to  Western  Texas,  including  Eastern  Colorado. 
Elsewhere  the  rainfall  for  February  shows  but  slight  deviations 
from  its  proportional  amount  with  reference  to  the  yearly  range. 
The  normal  rainfall-records  for  the  principal  cities  are  as  follows 
for  February  :  Denver,  0.5  ;  Colorado  Springs,  0.3  ;  Santa  Fe,  0.9; 
El  Paso,  0.5  ;  Prescott,  1.7  ;  Tucson,  0.9;  Salt  Lake  City,  1.8  ;  Los 
Angeles,  0.4;  San  Diego,  2.1  inches. 

Ilareh.  A  wet  mouth  for  the  western  part  of  California.  A  dry 
month  over  Western  Texas  and  the  eastern  part  of  New  Mexico.    In 

1  "The  terms  wet  and  dry,  with  reference  to  months,  are  something  more  than|relative  as  used 
in  this  report.  Here  it  is  defined  fully  with  reference  to  average  rainfall,  the  same  rule  being 
followed  as  has  been  employed  elsewhere.  A  wet  month  is  one  in  which  .50  per  cent,  more  rain 
falls  than  the  average,  and,  in  like  manner,  a  very  wet  month  is  one  in  which  double  the  usual 
amount  of  rain  occurs— that  is  to  say,  8.33  per  cent,  of  the  annual  rainfall  is  the  proportional 
amount  for  each  month,  so  that  under  the  definition  here  given  a  month  with  12.5  of  the 
average  yearly  rainfall  is  a  wet  month,  and  one  with  16.7  is  a  very  wet  month.  In  like  manner 
a  dry  month  is  one  in  which  the  average  rainfall  does  not  exceed  4.2  per  cent,  of  the  annual 
rainfall,  and  a  very  dry  month  is  one  in  which  2.1  per  cent.,  or  less,  of  the  annual  amount 
occurs." 

••:  Adapted  from  a  Report  on  the  Climatology  of  the  Arid  Regions,  etc.  By  General  A.  W. 
Greely,  Washington,  1891. 


238  MEDICAL  CLIMATOLOGY. 

Eastern  Colorado  the  rainfall  is  a  little  less  than  the  proportional 
share  for  the  month.  The  normal  rainfall-records  for  the  principal 
cities  are  as  follows  for  March  :  Denver,  0.9;  Colorado  Springs, 
0.6  ;  Santa  Fe,  0.7  ;  El  Paso,  0.3  ;  Prescott,  1.6  ;  Tucson,  0.9  ;  Salt 
Lake  City,  2.1 ;  Los  Angeles,  2.2  ;  San  Diego,  0.1  inch. 

April.  A  dry  month  in  the  southern  half  of  Arizona  and  New 
Mexico,  with  tendencies  in  localities  to  be  very  dry.  A  wet  month 
in  the  interior  valleys  of  Southern  California,  over  Western  Colo- 
rado, and  parts  of  Eastern  Utah  and  Northern  Texas.  Usually  a 
wet  month  for  Eastern  Colorado.  The  normal  rainfall-records  for 
the  principal  cities  are  as  follows  for  April  :  Denver,  2.1  ;  Colorado 
Springs,  1.5;  Santa  Fe,  0.8;  El  Paso,  0.1 ;  Prescott,  0.9  ;  Tucson, 
0.1  ;  Salt  Lake  City,  0.2;  Los  Angeles,  1.3;  San  Diego,  1  inch. 

May.  A  dry  mouth  ov^er  all  California,  the  western  half  of  New 
Mexico,  and  the  northern  half  of  Arizona,  and  a  very  dry  month  in 
Southern  Arizona.  A  wet  month  over  Texas  (except  in  the  neigh- 
borhood of  El  Paso)  and  Northeastern  Colorado.  In  Southeastern 
Colorado  very  wet.  The  normal  rainfall-records  for  the  principal 
cities  are  as  follows  for  May  :  Denver,  2.8;  Colorado  Springs,  2.5  ; 
Santa  Fe,  0.8;  El  Paso,  0.2  ;  Prescott,  0.5;  Tucson,  0.1;  Salt  Lake 
City,  2 ;  Los  Angeles,  0.3  ;  San  Diego,  0.3  inch. 

June.  The  mouth  is  very  dry  over  California,  Southern  Nevada, 
Southern  Utah,  and  Arizona,  and  is  dry  over  Western  Colorado. 
Over  extreme  Eastern  Colorado  it  is  wet.  The  normal  rainfall- 
records  for  the  principal  cities  are  as  follows  for  June:  Denver, 
1.4;  Colorado  Springs,  1.7;  Santa  Fe,  1.2;  El  Paso,  0.5;  Pres- 
cott, 0.1;  Tucson,  0.2;  Salt  Lake  City,  1.2  ;  Los  Angeles,  0.1; 
San  Diego,  0.1  inch. 

July.  A  very  dry  month  over  California.  A  very  wet  mouth  over 
Eastern  Colorado,  Western  Texas,  New  Mexico,  and  the  eastern  part 
of  Arizona.  It  is  a  dry  month  over  Western  Arizona  (except  in  the 
extreme  southwestern  part)  and  Southern  Utah.  The  normal  rainfall- 
records  for  the  principal  cities  are  as  follows  for  July  :  Denver,  1.6; 
Colorado  Springs,  3.2;  Santa  Fe,  2.7;  El  Paso,  1.6;  Prescott,  3  ; 
Tucson,  2.8  ;  Salt  Lake  City,  0.9;  Los  Angeles,  trace;  San  Diego, 
0.1  inch. 

August.  A  very  c?r«/ month  over  California  (where  it  is  practically 
rainle-ss).  It  is  very  wet  over  Arizona,  New  Mexico,  and  the  moun- 
tain region  of  Colorado  and  Southern  Utah.  The  normal  rainfall- 
records  for  the  principal  cities  are  as  follows  for  August :    Denver, 


ROCKY  MOUNTAIN  REGION  239 

1.5;  Colorado  Springs,  2.2;  Santa  Fe,  2.7;  El  Paso,  0.2;  Pres- 
cott,  2.8;  Tucson,  2.3;  Salt  Lake  City,  1.4;  Los  Angeles,  0.1; 
San  Diego,  0.1  inch. 

September.  Very  dry  and  nearly  rainless  in  California,  dry  over 
Nevada  and  Southern  Utah  and  Eastern  Colorado.  Wet  over  all  of 
Texas.  The  normal  rainfall-records  for  the  principal  cities  are  as 
follows  for  September  :  Denver,  0.8;  Colorado  Springs,  1  ;  Santa 
Fe,  1.6;  El  Paso,  1.7  ;  Prescott,  1.1 ;  Tucson,  1.2;  Salt  Lake  City, 
1  :  Los  Angeles,  trace;  San  Diego,  0.1  inch. 

October.  The  month  is  dry  over  Western  Arizona,  Southern  Cali- 
fornia, and  Southern  Nevada.  Elsewhere  about  the  proportional 
amount  of  the  annual  rainfall,  or  a  little  less,  occurs.  The  normal 
rainfall-records  for  the  principal  cities  are  as  follows  for  October  : 
Denver,  0.9;  Colorado  Springs,  0.6;  Santa  Fe,  1;  El  Paso,  0.8; 
Prescott,  0.6  ;  Tucson,  0.6  ;  Salt  Lake  City,  1.8  ;  Los  Angeles, 
0.7;  San  Diego,  0.3  inch. 

November.  A  wet  mouth  in  Northern  California.  From  the  one 
hundredth  meridian  to  the  crest  of  the  Rocky  Mountains  it  is  a  dry 
mouth.  The  normal  rainfall-records  for  the  principal  cities  are  as 
follows  for  November:  Denver,  0.6;  Colorado  Springs,  0.3;  Santa 
Fe,  0.9;  El  Paso,  0.5  ;  Prescott,  0.8  ;  Tucson,  0.5  ;  Salt  Lake  City, 
1.5  ;  Los  Angeles,  1.6  ;  San  Diego,  1  inch. 

December.  X  dry  month  over  Western  Texas,  Western  New  Mexico, 
and  Eastern  Colorado,  with  a  tendency  to  be  very  dry  in  extreme  East- 
ern New  Mexico  and  extreme  Southeastern  Colorado.  The  month 
is  very  wet  over  Western  A  rizoua  and  California.  The  normal  rain- 
fall-records for  the  principal  cities  are  as  follows  for  December  : 
Denver,  0.7;  Colorado  Springs,  0.3  ;  Santa  Fe,  0.8  ;  El  Paso,  0.4; 
Prescott,  1.8;  Tucson,  1.2;  Salt  Lake  City,  2.1;  Los  Angeles,  3.7; 
San  Diego,  2.1  inches. 

"It  must  be  clearly  understood  that  these  terms — wet,  very  tvet, 
dry,  and  very  dry — refer  not  to  the  absolute  quantity  of  rainfall  over 
the  regions  mentioned,  but  to  the  average  monthly  quantities  with 
reference  to  the  proportional  part  of  the  annual  rainfall— that  is,  if 
equitably  distributed,  8.33  per  cent,  of  the  year's  rain  would  fall 
in  each  month.  "^ 

1  The  normal  precipitation  of  cities  is  taken  from  the  Report  of  the  Chief  of  the  Weather 
Bureau  (1892),  Report  ou  the  Climate  of  Arizona  (1891),  and  the  records  of  the  United  States 
Weather  Bureau  at  Denver  (1S95),  and  are  for  the  following  years  of  record  :  Denver,  26  years  ; 
Colorado  Springs,  16  years ;  Santa  Fe,  33  years  ;  El  Paso,  28  years ;  Prescott.  18  years  ;  Tucson 
14  years ;  Salt  Lake  City,  24  years  ;  Los  Angeles,  21  years  ;  ami  San  Diego,  42  years. 


240  MEDICAL  CLIMATOLOGY. 


Colorado. 


For  the  purposes  of  health-resort  stations  the  climate  of  Colorado 
may  be  divided  into  three  groups:  first,  the  prairie-plains,  ranging 
from  4000  to  6000  feet  in  elevation;  second,  the  foot-hills  and 
adjoining  valleys,  varying  from  6000  to  7000  feet;  third,  the  natural 
parks,  varying  from  7000  to  10,000  feet. 

It  has  been  estimated  that  there  are  ov^er  130  peaks  of  the  Rocky 
Mountains  in  Colorado  between  13,500  and  14,500  feet  in  height, 
of  which  Blanca  Peak  (14,483  feet)  in  the  Sangre  de  Cristo  range 
is  the  highest.  Of  this  number  but  sixty  or  seventy  have  been 
named.  Pike's  Peak  (14,134  feet)^  is  twenty-fourth  in  height  on 
the  list. 

The  rainfall  of  the  State  varies  from  8  to  22  inches,  with  an  aver- 
age of  15  inches  per  annum,  and  is  more  copious  near  the  mountain- 
peaks.  It  does  not,  however,  necessarily  increase  with  the  altitude, 
as  Gunnison,  7680  feet,  with  10  inches,  and  Leadville,  10,200  feet, 
with  12.80  inches,  have  each  less  rain  than  Denver,  5300  feet,  14|- 
inches. 

The  rainfall  in  Colorado  does  not  reach  great  annual  extremes. 
In  Denver  the  maximum  is  21 J  inches  (1891)  and  the  minimum 
9.4  inches  (1890).  In  Colorado  Springs  the  extremes  are  18|  inches 
(1872)  and  U  inches  (1893).' 

The  influence  of  a  high  mountain-chain  or  peak  in  forcing  the 
moisture  out  of  warm  air-currents  through  condensation  is  shown 
by  the  summer  rains  around  Pike's  Peak.  The  mornings  in  July 
and  August  are  invariably  fair  ;  for  several  hours  after  sunrise  there 
is  not  a  cloud  in  the  sky ;  then  the  hot  air  of  the  southern  plains 
rises,  and  clouds  begin  to  gather,  until  by  noon  the  peak  is  likely 
to  be  quite  obscured.  When  this  heated  air  meets  the  colder 
currents  its  moisture  is  condensed,  and  a  sharp  fall  of  rain  is  the 
result. 

There  may  be  one  or  two  showers  during  the  afternoon,  but 
the  night  is  usually  clear  and  the  morning  bright  as  before. 
These  showers,  which  are  apt  to  be  of  daily  occurrence  during  a  por- 
tion of  July  and  August,  form  one  of  the  pleasant  characteristics  of 

1  Elevation  from  the  records  of  the  United  States  Weather  Bureau.  A  meteorological  station 
was  maintained  by  the  government  for  several  years  on  the  summit  of  Pike's  Peak.  It  waa 
discontinued  October  1,  1894. 

-  Compare  with  Los  Angeles  rainfall :  extremes  of  40>^  inches  (1884)  and  5)^  inches  (1881). 


ROCKY  MOUNTAIN  REGION.  241 

the  summer  climate,  as  tbey  materially  cool  the  air,  aud  the  total 
precipitation  is  not  very  large  during  what  is  called  the  rainy 
season.  The  normal  monthly  rainfall  at  Boston  or  New  York,  for 
instance,  is  greater  than  at  Colorado  Springs  during  this  "  rainy" 
period. 

The  total  yearly  precipitation  on  Pike's  Peak  is  less  than  one 
might  expect,  being  barely  30  inches,  and  its  local  character  is  in- 
dicated by  the  fact  that  on  the  plains  at  its  base  the  rainfall  is  but 
half  as  much — 14  or  15  inches.^  In  Colorado,  east  of  the  Conti- 
nental Divide,  the  rainfall  of  April  and  May  frequently  equals  that 
of  July  and  August,  when  about  30  per  cent,  of  the  annual  precipi- 
tation occurs. 

On  the  eastern  plains  snow  falls  occasionally  during  the  winter 
and  early  spring,  and  more  rarely  in  the  late  autumn ;  but  it 
seldom  lies  for  any  length  Jof  time  on  account  of  the  bright,  hot 
sunshine. 

The  difference  between  the  temperature  in  the  sunlight  and  the 
temperature  in  the  shade  in  these  elevated  regions  is  at  all  times 
very  marked,  being  from  40°  to  60°  F.  ''The  character  of  the  sun- 
light of  high  altitudes  is  a  nearer  approach,  if  possible,  to  white  light 
than  at  sea-level."^ 

After  a  cold  night  in  winter,  with  the  mercury  perhaps  down  to 
zero,  it  will  be  warm  enough  during  the  day  for  an  invalid  to  lie  out 
in  the  sunshine.  A  table  of  sun-temperatures  taken  in  1 886-' 87 
shows  a  range  of  maxima  from  December  to  March  of  112°  to  123°, 
and  of  minima  during  those  months  from  95°  to  108°.  The  extreme 
maximum  sun-temperature  for  the  year  was  155°  in  July.^ 

The  average  air-temperature  for  the  month  of  January  along  the 
plains  under  the  eastern  foot-hills  is  30°,  which  means  the  general 
average  of  twenty-four  hours,  and  includes  the  extreme  minima  of 
the  cold  nights.  The  mean  monthly  temperature  of  Colorado  Springs 
for  January,  1887,  taken  at  2  p.m.  (in  the  shade),  was  38°,  and  for 
the  winter  months  of  1803,  taken  at  12  m.,  40°;  while  the  mean 
monthly  sun-temperature  for  January,  1894,  was  60°.  Air-tem- 
perature (January,  1894),  monthly  mean,  28°;  per  cent,  of  sunshine 
(January,  1894),  0.66.  In  Canon  City  during  January,  1887,  the 
monthly  mean,  taken  at  2  p.m.,  was  42°.      In  Denver  the  tempera- 

1  For  details  of  rainfall,  see  Tables  I.  and  V.  to  X. 

3  Rocky  Mountain  Healtb-resorts.    C.  Denison,  M.D. 

3  An  Invalid's  Day  in  Colorado  Springs.    S.  E.  Solly,  M.D..  1888. 

16 


242  MEDIC  iL  CLIMATOLOGY. 

tare  of  the  air  at  1  P.ivf.  (mean  of  two  years,  1884-'85  and  1886) 
was  31°  for  January,  and  the  mean  for  winter  37°.  The  solar 
temperature  for  winter,  taken  at  the  same  hour,  was  99°,  a  differ- 
ence of  62°  between  sun  and  shade.  The  mean  monthly  solar  tem- 
perature for  the  three  summer  months  (1886)  was  144°;  for  the 
year  it  was  120°.^ 

The  unexpected  mildness  of  the  Colorado  climate-  is  well  described 
by  Dr.  Carl  Ruedi,  of  Denver,  who  formerly  practised  in  Davos- 
Platz,  Switzerland.  In  October,  1891,  he  paid  a  visit  to  a  small 
place  called  Hygiea,  situated  forty  miles  north  of  Denver,  at  an 
elevation  of  5000  feet.  When  he  left  the  house  to  look  over  the 
grounds  he  first  stepped  into  the  orchard,  where  ''the  ripe  apples 
and  pears  were  tumbling  off  the  trees."  Then  he  went  through  a 
chestnut-grove,  and  saw  at  the  further  end  of  the  garden  watermelons 
and  sugarmelons  sunning  their  backs  and  only  waiting  to  be  plucked. 
Tomatoes  and  other  vegetables,  from  cabbage  to  peppers,  were  grow- 
ing everywhere.  Hef erring  to  Davos,  he  adds:  "  No  cherry  or  fruit 
tree  can  bring  forth  its  savory  product,  and  even  potatoes  and  barley 
attain  a  very  doubtful  success."^  One  reason  for  this  difference  is 
that  the  limit  of  vegetable  growth  is  much  higher  in  Colorado, 
the  '*  timber-line"  being  11,000  feet  above  the  sea,  while  in  Swit- 
;?erland  it  is  8500  feet. 

In  making  his  comparison  Dr.  Ruedi  comes  to  the  conclusion 
that  ''Colorado,  and  probably  also  New  Mexico  and  Arizona, 
have  in  their  mountains  natural  advantages  and  climatic  conditions 
which  equal  or  surpass  the  best  European  health-resorts  of  this 
character." 

The  great  dryness  of  the  elevated  plains  of  Colorado  is  well 
known.  With  a  general  mean  of  relative  humidity  during  the 
year  of  50  per  cent,  and  an  average  annual  temperature  of  50°  F., 
the  air  shows  but  2.04  grains  of  moisture  to  the  cubic  foot,  which  is 
a  small  amount  of  absolute  humidity  for  the  average  of  the  four 
seasons.  It  is  this  quality  which  enables  one  to  bear  the  changes 
from  an  extremely  high  to  a  low  temperature,  or  vice  versa,  with 
comfort.     A  temperature  of  56°  or  58°,  for  instance,  is  not  unpleas- 

1  See,  also,  articles  on  Denver  and  Colorado  Springs. 

-  It  may  be  interesting  in  this  connection  to  call  attention  to  the  low  average  air-tempera- 
ture of  the  New  England  coast  during  the  month  of  January,  as  indicated  by  Boston  26°, 
Portland  22°,  and  Eastport  20°,  taking  the  government  records  for  about] twenty  years.  Davos- 
Platz  has  for  normal  mean  of  January,  from  observation  of  eight  years,  a  teinperatiire  of  18°  F. 

3  Comparison  of  the  Winter  Health-resorts  in  the  Alps  and  Rocky  Mountains.  Carl  Ruedi, 
M.D.    See  Estes  Park. 


ROCKY  MOUNTAIN  REGION.  243 

aut  if  the  air  is  dry,  while  the  moist  atmosphere  of  Florida,  or  even 
Southern  California,  is  often  chilly  and  disagreeable. 

The  wind-movement  of  the  open  plains  is  a  marked  feature  of 
their  climate  and  at  times  appears  to  be  unpleasantly  prominent, 
although  an  examination  of  its  action  will  show  the  following  sur- 
prising result.  Taking  Denver  as  an  illustration,  the  monthly  and 
annual  wind-velocity  is  found  to  be  less  than  that  of  New  York, 
Boston,  Philadelphia,  Chicago,  San  Antonio,  Key  West,  St.  Paul, 
San  Francisco,  and  numerous  other  representative  localities  (see 
Table  v.). 

A  possible  explanation  of  its  apparent  force  in  Colorado  is  that 
the  wind  blows  with  great  irregularity,  frequently  in  small  squalls 
or  gusts,  as  on  the  seacoast.  Another  reason  why  it  is  felt  more 
strongly  is  that  the  towns  are  not  closely  built  as  in  Eastern  cities, 
and  detached  houses  and  wide  streets  offer  a  greater  sweep  for  the 
wind.  In  the  sheltered  valleys  of  the  foot-hills  and  in  the  smaller 
parks  there  is  much  less  wind,  the  amount  varying  with  the  local 
conditions. 

Along  the  plains  east  of  the  mountains  the  prevailing  pleasant 
weather  winds  are  from  the  south,  southwest,  and  west,  while  their 
opposites,  the  north,  northeast,  and  east,  bring  most  of  the  stormy 
weather. 

The  advantages  of  continuous  air-movement  are  well  known. 
Perfect  stillness  of  the  air  is  only  desirable  in  freezing  weather. 
In  other  words,  the  warmer  the  atmosphere  the  more  is  a  moderate 
air-movement  desirable. 

After  studying  the  matter  of  the  natural  climate,  the  most  impor- 
tant essentials  of  an  invalid's  knowledge  are  the  advantages  of  par- 
ticular localities  as  regards  drainage,  soil,  water,  accessibility,  the 
quality  of  the  hotels  and  boarding-houses,  and  the  possibility  of 
securing  good  food  and  cooking.  Especial  attention  should  always 
be  given  to  avoiding,  if  possible,  muddy  or  "  adobe  "^  soil  and 
hard  or  "  alkali  "  water. 

Colorado  is  more  favored  than  some  of  her  neighbors  in  having 
several  resorts  of  considerable  size  where  good  accommodations  can 
be  relied  on ;  but  even  here  the  list  is  not  extensive. 

As  most  of  these  resorts  are  described  later  in  detail,  it  will  only 

1  Adobe  (ay-do'bay).  Throughout  the  southwestern  portion  of  the  United  States  the  term  adobe 
is  applied  indiscriminately  to  semi-dried  bricks,  to  houses  built  of  such  bricks,  or  to  the  tena- 
cious, clayey  loam  or  soil  of  which  they  are  made. 


244  MEDICAL  CLIMATOLOGY. 

be  uecessary  to  refer  in  a  general  way  to  the  advantages  of  the  plains 
lying  east  of  the  protecting  shelter  of  the  mountains. 

These  health  stations  may  be  said  to  extend  from  Estes  Park, 
Longmont,  and  Boulder  south  to  Caiion  City  or  Pueblo,  with  Den- 
ver and  Colorado  Springs  as  places  of  refuge  or  main  points  of 
supply.  The  elevation  of  this  country  ranges  from  4700  to  7400 
feet.  It  is  not  easy  in  Colorado  to  get  below  an  altitude  of  4000 
feet,  certainly  not  without  enduring  great  privations,  which  are  not 
advisable  for  a  delicate  invalid.  If  a  decidedly  lower  altitude  is 
desired,  it  should  be  sought  in  New  Mexico,  in  Western  Texas,  or 
in  Arizona,  where  any  elevation  from  100  to  7000  feet  or  more  can 
be  found,  or  in  Southern  California,  if  the  influence  of  a  marine 
climate  is  not  objectionable. 

The  belt  of  45°  to  50°  F.  mean  annual  temperature  embraces 
Denver,  Fort  Collins,  Greely,  Boulder,  Colorado  Springs,  and 
Trinidad.  The  Continental  Divide  runs  irregularly  north  and 
south  through  Colorado,  usually  between  the  106th  and  107th  de- 
grees of  longitude. 

An  attractive  feature  of  the  Rockies  in  Colorado  is  the  natural 
parks — great  tracts  of  land  with  meadows  and  pastures,  brooks  and 
trees,  lying  at  high  altitudes,  sheltered  on  every  side  by  huge  ranges 
of  mountains.  Each  enclosed  valley  has  its  own  peculiar  climate, 
and  offers  opportunities  for  hunting  and  fishing  and  the  exploration 
of  grand  and  beautiful  scenery.  During  the  summer  and  early 
autumn  these  regions  are  most  attractive  for  visitors  and  those 
strong  enough  for  camping  out. 

North  Park  lies  at  an  elevation  of  8000  feet  and  contains  2500 
square  miles. 

Middle  Park  has  an  elevation  of  7500  feet  and  an  area  of  3000 
square  miles.  It  is  sixty-five  by  forty-five  miles  in  extent.  Its 
climate  is  milder  than  that  of  North  Park.  Within  its  boundaries 
are  well-known  sulphur  springs. 

South  Park  has  an  elevation  of  9000  feet.  It  is  sixty  miles  long 
by  thirty  miles  wide,  and  contains  2200  square  miles. 

San  Luis  Park  is  the  largest  of  all,  containing  18,000  square  miles. 
Its  average  elevation  is  a  little  under  7000  feet.  It  has  a  warm 
climate  and  is  more  thickly  wooded  than  any  of  the  others.  All 
these  parks  contain  game  and  trout,  and  fine  feeding-ground  for 
cattle. 

Dr.  Denison  says  :  "  We  have  every  indication  that  these  basins 


BOCKY  MOUNTAIN  REGION.  245 

were  ouce  beds  of  immense  bodies  of  water,  wliich,  breaking  through 
their  rocky  barriers,  cut  deep,  rugged  gorges  or  canons  down  which 
the  rivers  have  flowed  for  centuries,  depositing  their  debris  below 
the  foot-hills.  That  the  plains  are  overlaid  by  mountain- washings 
is  very  evident  to  the  intelligent  observer."^ 

Egeria,  Estes,  Antelope,  and  Manitou  Parks,  and  other  smaller 
sheltered  valleys  are  more  or  less  known  as  summer-resorts,  and  in 
some  of  them  good  board  can  be  found. 

No  fully  equipped  weather-stations  have  been  established  in  the 
large  parks,  but  there  have  been  a  few  voluntary  observers,  from 
whose  reports  to  the  United  States  Weather  Bureau  the  following 
details  are  taken : 

San  Luis,  7946  feet  elevation.  Temperature  (average  for  two  years, 
1891-'92),  autumn,  44°;  winter,  20°;  spring,  40°;  summer,  62°. 
Annual  mean,  41°;  maximum,  91°;  minimum,  — 25°.  Average  for 
January,  15°;  July,  66°.  Rainfall,  1891, 18.85  inches;  1892, 11.04 
inches;  1893,  11  inches.      Average  for  the  three  years,  13.6  inches. 

Como,  in  Middle  Park,  shows  a  temperature  even  lower,  as  the 
annual  average  (for  two  years)  is  83°,  with  the  mean  for  July,  55°; 
maximum,  78°;  minimum,  — 14°.  Rainfall,  1891,  15.72  inches; 
1892,  10.48  inches;  1893, 12.97  inches.  An  average  of  13  inches  for 
those  years.^ 

In  making  a  summary  of  the  climate  of  Colorado,  Dr.  C  T.  Wil- 
liams, of   Loudon,  says  :    "  The  chief  elements  appear  to  be — 

"  1.  Diminished  barometric  pressure,  owing  to  the  altitude,  which 
throughout  the  greater  part  of  the  State  does  not  fall  below  5000 
feet."  Dr.  Williams  also  quotes  from  General  A.  W.  Greely's 
American  Weather  the  interesting  statement  that  'Mt  has  been 
found  that  the  actual  barometric  pressure  in  the  Rocky  Mountains, 
generally  at  altitudes  above  4000  feet,  attains  its  minimum  in  Janu- 
ary and  its  maximum  in  July  and  August,  and  that  tiie  barometric 
phases  are  of  the  same  kind,  in  reference  to  the  annual  mean,  as  the 
temperature-phases  at  such  stations.  This  phenomenon  of  atmos- 
pheric pressure  is  the  reverse  of  that  in  parts  of  the  United  States 
at  low  elevation,  and  results,  according  to  General  Greoly,  from  the 
lower  average  temperature  of  the  winter  months  contracting  the 
great  body  of  air,  so  that  much  of  it  is  brought  below  the  summit 
of  the  mountains,  while  in  summer  the  reverse  conditions  obtain. 

1  Rocky  Mountain  Health-resorts     C.  Deuison,  M.D. 

-  Aerotherapeutics.    The  Lumleian  Lectures  for  1893.    London. 


246  MEDICAL  CLIMATOLOGY. 

'^  2.  Great  atmospheric  dryness,  especially  in  winter  and  autumn, 
as  shown  by  the  small  rainfall  and  the  low  percentage  of  relative 
humidity. 

"  3.   Clearness  of  atmosphere  and  absence  of  fog  or  cloud. 

''4.  Abundant  sunshine  all  the  year  round,  but  especially  in 
winter  and  autumn. 

''5.  Marked  diathermancy  of  the  atmosphere,  or,  as  Dr.  Denison 
expressed  it,  the  '  increased  facility  by  which  the  solar  rays  are 
transmitted  through  au  attenuated  air,'  producing  an  increase  in  the 
difference  of  sun-  and  shade-temperatures  varying  with  the  elevation 
in  the  proportion  of  1°  F.  for  every  rise  of  235  feet. 

"  6.  Considerable  air-movement,  ev^en  in  the  middle  of  summer, 
which  promotes  evaporation  and  tempers  the  solar  heat. 

"  7.   The  presence  of  a  large  amount  of  atmospheric  electricity. 

"Thus  the  climate  of  Colorado  is  dry  and  sunny,  with  bracing 
and  energizing  qualities,  permitting  outdoor  exercise  every  day,  all 
the  year  round,  the  favorable  results  of  which  may  be  seen  in  the 
large  number  of  former  consumptives  whom  it  has  rescued  from  the 
life  of  invalidism  and  converted  into  healthy,  active  workers." 

Estes  Park  (average  elevation,  7200  feet).  Estes  Park  is  situ- 
ated sixty  miles  northwest  of  Denver,  on  a  branch  line  of  the  Chi- 
cago and  Burlington  Railroad.  From  Lyoos,  which  is  the  present 
end  of  the  railroad,  it  is  necessary  to  stage  twenty  miles,  usually  in 
a  light,  covered  wagon.  The  road  winds  through  the  picturesque 
St.Vrain  Canon,  which  was  once  known  as  Muggiu's  Gulch. 

Estes  Park  is  a  plateau  about  ten  miles  long  and  six  miles  wide, 
with  a  number  of  little  side-valleys.  "  In  general  contour  it  is  not 
unlike  the  other  valleys  which  make  up  the  park  system  of  Colo- 
rado, abounding  in  gentle  slopes,  dark  pines,  and  beautiful  winding 
trails  leading  from  the  open  glades  of  the  valley  up  dark  canons. 
Its  clear  brooks,  fed  by  snowbanks  high  up  on  the  mountain-side, 
and  filled  with  speckled  trout,  unite  in  one  large  stream,  the  Big 
Thompson,  which  breaks  its  way  from  the  hills  to  the  plains  below. 
From  anv  of  the  neig-hboring'  mountains  the  view  from  this  charm- 

.-  OCT 

ing  little  valley  is  one  of  tranquil   beauty,  in  marked  contrast  with 
the  sublimity  of  its  surroundings. '" 

Dr.  Carl  Ruedi,  of  Denver  (formerly  of  Davos),  had  weather- 
observations  taken  during  the  winters  of  1891 -'92  and  1892-'93, 

1  Rocky  Mountain  Health-resorts.     C.  Denison,  M.D. 


ROCKY  MOUNTAIN  REGION.  247 

and  compared  them  with  similar  ones  taken  at  Davos,  with  a  result 
exceedingly  favorable  to  the  Colorado  resort. 

The  elevation  of  Davos  is  5200  feet.  A  greater  elevation  was 
selected  in  Colorado  because  the  timber-line  is  so  much  higher,  and  it 
was  desired  to  choose  a  location  similar  in  regard  to  the  character  of 
the  fauna  and  flora.  ' '  A  difference  of  2000  feet  between  Colorado  and 
Switzerland  is  required  to  put  invalids  under  the  same  conditions."^ 

Tlie  barometric  pressure  in  Colorado  is  remarkably  uniform. 
The  Estes  Park  record  shows  December,  1892,22.06  inches  ;  Janu- 
ary, 1893,  22.11  inches;  February,  22.01;  March,  22.01. 

The  percentage  of  relative  humidity  is  much  less  at  Estes  Park 
than  at  Davos. 

Dr.  Ruedi's  short  table  is  as  follows  : 

Relative  humiclity. 

Denver.  Estes  Park.                Davos.  Sentis.- 

October,  0.53  per  ct per  ct.  0.77  per  ct.  0.85  per  ct. 

November,  0.45  "  0.40       "  0.79      '■  0.76      " 

December,  0.60  "  0.47       "  0.81       "  0.77       " 

January,  0.39  "  0.38       "  0.86       "  0.71       " 

February,  0.54  "  0.49      "  0.82       "  0.79       " 

March,  0.52  "  0.41       "  ....       "  0.62       " 

The  following  table  is  compiled  from  a  record  of  the  rainfall  in 
Denver  for  ten  years  : 

November 0.577  inch 

December 0.370     " 

January 0.706     " 

February .  0.563     " 

March  .  .         • 1.080    " 

The  total  precipitation  for  ten  years  showed  an  average  of  0.759 
inch  for  each  of  the  months  given. 

A  comparison  of  the  rainfall  between  two  Swiss  stations  and  two 
in  Colorado  is  markedly  in  favor  of  Colorado  : 

Days  of  Precipitation. 

Denver,  28  in  6  months  (October  to  April)  .  .       6.79  inches. 

Estes  Park,    19  in  6  months  (October  to  April)    .  .       6.64     " 

Davos,  53  in  5  months  (October  to  March)  .  11.24     " 

Sentis,  103  in  6  months  (October  to  April)  .  .  30.52     " 

1  A  Comparison  of  the  Winter  Health-resorts  of  the  Alps  with  Some  Places  in  the  Rocky 
Mountains.    Carl  Ruedi,  M.D.    Denver,  1894. 

-  The  Sentis  is  an  isolated  peak  9500  feet  high,  and  the  observatory  is  2000  feet  above  tim- 
ber-line.   It  is  the  highest  point  in  Switzerland  where  official  observations  have  been  taken. 


248  MEDICAL  CLIMATOLOGY. 

The  record  of  hours  of  sunshine  during  the  winter  of  1891-'92 
shows  a  daily  average  from  November  to  February,  inclusive,  of 
2.85  hours  for  Davos  and  6.80  hours  for  Denver.  The  hours  of 
possible  sunshine  during  the  winter  of  1892-93  were  October  to 
February,  inclusive,  daily  average  :  Davos,  3. 26  hours ;  Denver, 
7.85  hours. 

The  hours  of  possible  sunshine  by  months  for  Estes  Park  and 
Davos  is  recorded  as  follows  : 

Davos.  Estes  Park. 

December 165  hours.  264  hours. 

January 182     "  268     " 

February 186     "  267     " 

March Not  received.     325     " 

(See  Table  VIII.) 

The  record  of  temperature  for  Estes  Park  is  not  reported  by  Dr. 
Ruedi  in  detail,  but  he  states  that  '*for  weeks  (in  winter)  you  read 
20°  to  40°  F.  at  7  a.m.,  40°  to  45°  at  1  p.m.,  25°  to  30°  at  9  p.m. 
The  only  variations  take  place  when  sharp  continental  winds  set  in, 
and  then  at  once  the  temperature  falls  very  low,  stays  low  until 
the  snowfall  has  set  in,  to  rise  again  to  the  usual  point  after  three 
days." 

The  greater  amount  of  electricity  in  Colorado  as  compared  with 
Switzerland  is  noticed  by  Dr.  Ruedi.  In  the  important  matter  of 
wind-velocity  he  considers  the  air-movement  in  the  sheltered  moun- 
tain-parks very  light.  While  the  wind-movement  for  the  year  will 
average  from  7  to  9  miles  per  hour  in  Denver  or  Colorado  Springs, 
in  Estes  Park  the  air  is  usually  still,  owing  to  the  protection  of  the 
surrounding  mountains. 

The  main  basin  of  Estes  Park  rises  from  an  elevation  of  6800 
feet,  near  the  base  of  Mount  Olympus,  to  about  7800  feet,  near 
Moraine,  which  is  seven  miles  further  up,  on  Divide  Creek.  Owing 
to  its  irregularity  of  configuration,  Estes  Park  cannot  all  be  seen  at  one 
time,  even  when  viewed  from  one  of  the  surrounding  peaks.  Numer- 
ous brooks  come  down  from  ravines  and  canons  and  flow  over  the 
meadows.  Pine-groves  are  scattered  over  the  park  and  on  the  slopes 
of  the  hills.  Several  large  cailons  leading  from  the  park  will  repay 
exploration.  They  contain  a  number  of  picturesque  waterfalls  and 
cascades. 

Good  trout-fishing  is  furnished  by  the  numerous  mountain-streams. 
Hunting  is  usually  sought  ''over  the  range"  to  the  west.  Long's 
Peak  (14,271  feet)  is  one  of  the  highest  elevations  in  Northern  Colo- 


ROCKY  MOUNTAIN  REGION.  249 

rado.      It  can  be  climbed  to  a  point  above  the  timber-b"ne  on  horse- 
back, but  the  journey  must  be  completed  on  foot. 

There  is  a  small  but  comfortable  hotel  in  the  park.  Accommo- 
dations can  also  be  secured  at  various  ranches. 

The  following  seasonal  meteorological  data  for  Moraine  are  based 
on  observations  for  five  years.  Mean  temperature:  winter,  24°; 
spring,  37°;  summer,  57°;  autumn,  43°;  annual,  40°.  For  Janu- 
ary, monthly  mean,  24°;  minimum,  — 17°.  For  July,  monthly 
mean,  60°;  maximum,  88°. 

Rainfall:  winter,  3.56  inches;  spring,  6.19  inches;  summer, 
4.25  inches;  autumn,  2.31  inches.     Mean  annual,  16.31  inches. 

Boulder  (elevation,  5300  feet;  population,  4000).  The  town 
of  Boulder  is  thirty  miles  northwest  from  Denver,  on  a  branch  of 
the  Union  Pacific  Railroad.  It  has  fair  hotels  and  has  a  local 
popularity  as  a  summer-resort. 

The  town  is  situated  close  to  the  foot-hills,  near  the  entrance  to 
Boulder  Cailon.  The  water-supply  is  drawn  from  a  reservoir  on 
Boulder  Creek,  five  miles  above  the  town.  Water  is  also  used 
from  wells,  from  springs,  and  from  the  creek.  There  are  no  sewers 
in  the  town.  Many  of  the  streets  are  well  shaded  and  bordered 
with  handsome  residences. 

The  Seltzer  Springs,  of  Springdale  (6500  feet),  are  ten  miles 
northwest.  From  Boulder  the  Union  Pacific  Railroad  has  built  a 
narrow-gauge  railroad  through  Boulder  Cailon  to  Sunset  (7696 
feet),  about  ten  miles  to  westward. 

The  mean  monthly  temperature  for  Boulder,  from  observations 
for  one  and  one-half  years,  is  as  fiallows:  winter,  30°;  spring,  49°; 
summer,  65°;  mean  for  January,  30°;  July,  69°.  As  the  month  of 
September  is  missing,  the  mean  for  autumn  and  the  year  cannot  be 
given.      They  would  each  be  probably  not  far  from  49°. 

No  reports  of  the  rainfall  for  a  complete  year  nor  records  of  the 
percentage  of  relative  humidity  and  wind-velocity  could  be  obtained. 
The  average  number  of  cloudy  days  during  the  winter  is  13. 

Denver  (elevation,  5300  feet;  population,  150,000;  latitude, 
39°  45'  north).  It  is  very  nearly  in  the  same  latitude  as  Balti- 
more. Its  altitude  is  easily  remembered,  as  the  business  portion  of 
the  city  is  said  to  be  exactly  one  mile  (5280  feet)  above  the  sea.  The 
streets  in  this  section  of  the  city  are  wide,  level,  and  paved  with 
asphalt. 

Julian  Ralph,  in  an  article  on  '' Colorado  and  its  Capital,"  first 


250  MEDICAL  CLIMATOLOGY. 

published  in  Harper^  s  Ifagazine,  says  :  "I  had  supposed  it  to  be  a 
mountain-city,  so  much  does  the  Eastern  man  hear  of  its  elevation, 
its  mountain-resorts,  and  its  mountain-air.  It  surprised  me  to  dis- 
cover that  it  was  a  city  of  the  plains."^  It  is  fifteen  miles  due  west 
to  the  foot-hills  and  thirty  or  forty  miles  to  the  highest  snow-clad 
peaks  of  the  range ;  yet  in  the  clear  air  they  seem  only  distant  a 
comfortable  walk  or  a  ride  of  an  hour  or  so.  There  are  a  number 
of  fine  office  and  mercantile  buildings  in  Denver.  To  quote  Mr. 
Ralph  once  more,  "  They  are  massive  and  beautiful,  and  they 
possess  an  elegance  without  and  a  roominess  and  lightness  within 
that  distinguish  them  as  superior  to  the  show  buildings  of  most  of 
the  cities  of  the  country."  There  is  a  large  and  lively  retail  dis- 
trict. The  animation  on  the  streets  usually  impresses  a  visitor  as 
being  greater  than  in  other  Western  towns  of  about  the  same  size 
— Kansas  City,  Omaha,  and  St.  Paul,  for  instance.  This  may  be 
partly  due  to  the  constant  coming  and  going  of  a  large  number  of 
invalids,  who  are  usually  accompanied  by  friends.  Many  of  these 
visitors  remain,  nearly  one-fifth  of  the  population  being  credited 
to  the  class  who  came  for  climate  and  health.  The  most  desirable 
residence- section  of  the  city  is  on  Capitol  Hill,  east  of  the  new 
capitol,  on  a  mesa  thirty  or  forty  feet  above  the  business  streets. 
Here  are  modern,  well-designed  dwellings,  some  of  great  size  and 
costliness,  always  standing  alone,  so  that  light  and  air  have  free 
access,  and  each  house  is  surrounded  by  its  own  grounds.  This 
generous  method  of  building  spreads  the  city  over  an  unusual  amount 
of  territory,  but  insures  pleasanter  homes  and  a  healthier  way  of 
living  than  the  customary  method  adopted  in  large  cities  of  build- 
ing in  crowded  blocks. 

Denver  is  unusually  well  provided  with  electric  and  cable  street- 
roads.  The  supply  of  water  is  ample,  derived  both  from  submerged 
drains  in  the  Platte  River  and  from  a  reservoir  in  the  mountains, 
thirty-five  miles  distant.  The  water  from  the  first- named  of  these 
systems  is  alkaline.  There  are  a  number  of  artesian  wells,  a  source 
of  supply  upon  which  many  of  the  hotels  rely. 

Denver  possesses  a  number  of  good  hotels,  the  principal  one  being 
surpassed  by  few  Eastern  hotels.  There  are  six  national  banks,  four 
theatres,  two  of  them  of  the  highest  class,  and  well-built  churches  of 
all  denominations.     Denver  has  a  number  of  social  clubs,  three  of 

1  The  Great  West.    Julian  Ralph,  New  York,  1894. 


ROCKY  MOUNTAIN  REGION.  251 

which — the  Denver  Club,  the  University  Club,  and  the  Athletic 
Club — have  each  a  fine,  modern  club-house. 

The  visitor  will  find  congenial  society  and  better  opportunities 
for  business  in  a  city  of  this  size  than  in  the  smaller  towns. 

The  markets  are  well  supplied  with  the  best  beef  from  Kansas, 
and  fresh  fruit  and  vegetables  from  the  fruit-growing  centres 
of  Colorado  and  from  the  warmer  climates  of  Texas,  Arizona 
and  California.  The  stores  are  large  and  well  equipped  and  sup- 
plied. 

Denver  has  about  315  sunny  days  during  the  year.  It  is  a 
pleasant  place  in  which  to  spend  the  winter.  The  weather  is  usu- 
ally mild  enough  for  a  light  overcoat,  except  during  a  week  or  so 
of  snow  in  December  and  perhaps  the  same  length  of  time  in  Feb- 
ruary. The  direct  rays  of  the  sun  usually  melt  the  snow  in  a  few 
hours,  and  the  ground  lies  dry  and  unfrozen  nearly  all  winter.  The 
advantages  of  the  Colorado  plains  as  a  winter-resort  should  be  better 
known.  The  contrast  between  the  storms  and  cold  of  the  Eastern 
or  Northwestern  States  and  the  dry  ground,  moderate  temperature, 
and  constant  sunshine  of  the  country  sheltered  by  the  Rocky  jSIoun- 
tains  is  always  a  matter  of  astonishment  to  those  who  have  had  no 
previous  knowledge  of  the  climate.  Reference  to  the  records  of  the 
Weather  Bureau  will  show  the  surprising  fact  that  the  climate  of 
Denver  greatly  I'esembles  that  of  Prescott — a  town  in  the  middle 
of  Arizona — so  much  further  south  that  it  would  be  natural  to  ex- 
pect a  much  milder  climate.  As  Denver  is  now  a  city  of  sufficient 
size  and  resources  to  gratify  any  want,  and  is  less  than  fifty  hours 
by  rail  direct  from  New  York,  its  desirability  as  a  place  of  residence 
compared  to  the  half-civilized  adobe-towns  of  the  southern  alkali- 
country  is  obvious. 

During  the  spring  the  wind — especially  in  the  afternoons — be- 
comes annoying,  as  there  is  frequently  a  great  deal  of  dust  Hying 
about.  The  presence  of  the  smelters  north  of  the  city  is  sometimes 
noticeable  on  account  of  the  amount  of  objectionable  smoke  which, 
like  a  fine  brown  haze,  fills  the  lower  business  streets.  This  condition 
of  the  atmosphere  is  usually  due  to  a  north  wind,  and  to  avoid  it  as 
much  as  possible  a  residence  east  or  southeast  of  the  capitol  should 
be  secured.  "  There  is  a  feeling  that  the  air  at  times  is  being  con- 
taminated by  the  smoke  and  gases  from  the  massive  smelting-works, 
containing,  as  they  do,  volatilized  galena  (lead),  arsenic,  antimony, 
etc.,  although  an  effort  is  being  made  to  condense  these  from  the 


252  3IEDWAL  CLIMATOLOGY. 

smoke,  as  is  done  in  other  smelters.  The  same  objection  is  increas- 
ing against  Pueblo  aud  El  Paso."^ 

As  before  stated,  the  business  streets  have  asphalt  pavements. 
In  the  surrounding  residence-districts  the  soil  is  usually  sandy,  but 
in  some  places  it  is  very  tenacious  after  a  rain.  There  are  occa- 
sional outcroppings  of  clay  on  Capitol  Hill— the  neighborhood  of 
which  should  be  avoided. 

The  monthly  average  temperature  for  January  is  27°  F.;  for  July, 
73°;  for  the  year,  50°  (means  for  twenty  years).  Number  of  days 
in  the  year  above  90°,  21;  below  32°,  143  ;  cloudy  days,  57;  stormy 
days,  73  (means  for  six  years). 

The  hourly  velocity  of  the  wind  in  Denver  from  the  Government 
records  for  ten  years  shows  a  yearly  average  of  a  little  less  than  7 
miles  per  hour. 

The  total  wind-movement  for  the  year  1893  averaged,  for  the  full 
day  of  twenty-four  hours,  8  miles  per  hour  or  193  miles  per  day. 
During  the  extreme  length  of  what  I  have  termed  the  'invalid's 
day,"  from  8  a.m.  to  6  p.m.,  it  blew  at  the  rate  of  9.2  miles  an  hour. 
The  smallest  wind-movement  was  from  2  a.m.  to  9  a.m.,  when  it  aver- 
aged Q.Q  miles  an  hour.  The  greatest  v^elocity  was  usually  in  the 
afternoon  between  the  hours  of  1  and  5  p.m.,  when  it  averaged  10.5 
miles  per  hour." 

Occasionally  wind-storms  come  up  during  the  night,  aud  the 
velocity  at  that  time  is  greatly  increased.  A  record,  however,  of 
the  number  of  days  with  gales  (wind  forty  miles  per  hour  or  over) 
during  the  year  1892  shows  3  days  for  Denver  as  against  3  days 
for  Santa  Fe,  15  days  for  El  Paso,  4  days  for  St.  Paul,  6  days  for 
Xew  York,  8  days  for  Boston,  and  59  days  for  Chicago.  In  Den- 
ver a  record  of  the  high  winds  (18  miles  per  hour  or  over)  during 
the  year  1886  was  23  days. 

The  record  of  sunshine  for  Denver  for  three  years  (1891,  1892, 
1893),  as  reported  by  the  United  States  AVeather  Bureau,  is  given 
herewith,  adapted  from  the  record  for  each  month.  For  purposes 
of  comparison  the  record  for  Davos-Platz  for  six  years,  adapted 
from  the  tables  prepared  by  Arthur  William  Waters,  Esq.,  is 
included: 

1  Health  Journal.    W.  P.  Roberts,  M.D. 

-  Fourth  Report  of  State  Board  of  Health,  Colorado.    Denver,  1894.    Weather-tables. 


ROCKY  MOUNTAIN  REGION. 


253 


Monthly  means. 


Sunshine-record. 


Winter.     Spring.     Summer.  Autumn.      Year. 


Percentage  of  possible  sunshine—  Per  cent. '  Per  cent,  i  Per  cent    Per  cent 

Denver {        62  60  66  71 

Davos-Platz i        57  52  55        .        52 

Hours  of  actual  sunshine—  Hours.       Hours.       Hours.       Hours. 

Denver i        188  242  290  243 

Davos-Platz  ......  100  166  196  126 


Per  cent. 
65 


54 


Hours. 
240 


The  general  weather-characteristics  are  much  the  same  as  at  Colo- 
rado Springs,  except  that  the  rainfall  at  Denver  is  about  2  inches 
less  during  the  summer  season  and  the  snowfall  is  two  or  three 
times  greater  in  winter.  There  are  also  more  hot  days  during  the 
summer. 

Eighteen  miles  northeast  of  Denver,  on  the  Burlington  Railroad, 
is  the  Colorado  Carlsbad  Spring,  the  water  of  which  is  bottled  for 
commercial  purposes.     An  analysis  by  Karl  Langenbeck  yielded: 


Sodium  sulphate 

Sodium  ctiloride 

Calcium  carbonate  . 

Sodium  carbonate    . 

Magnesium  carbonate 

Potassium  sulphate,  iodide,  and  bromide 

Iron,  aluminum,  and  silica     . 

Total  solids 


Grains  per  gallon. 

.       87.16 

.       10.00 

.       19.70 

2.44 

3.58 

trace 

trace 


122.88 


Colorado  Springs  (elevation,  6000  feet ;  population,  22,000). 
This  well-known  health-resort  is  seventy-five  miles  south  of  Denver. 
It  is  well  located  on  gravel-soil  which  extends  to  a  depth  of  sixty  feet 
and  insures  dryness  and  good  natural  drainage.  The  town  has  a 
system  of  sewerage,  electric  lights,  and  electric  street-cars.  The 
supply  of  good  water  from  mountain-sources  is  ample.  The  streets 
are  wide,  level,  and  well  shaded  by  trees,  usually  cotton  woods. 
There  are  good  stores,  three  banks,  an  opera-house,  several  first- 
class  hotels,  one  of  which  ranks  with  the  best  hotels  in  the 
State,  a  fine  social  club-house,  and  remarkably  fine  churches  for  a 
place  of  its  size.  The  residences  are  detached  and  surrounded  by 
handsome  lawns.  There  are  a  surprising  number  of  large,  costly 
dwellings,  built  in  excellent  architectural  taste,  giving  the  town  the 
appearance  of  a  long-settled,  prosperous  Eastern  city.     Five  miles 


254  MEDICAL  CLIMATOLOGY. 

to  the  west  are  the  foot-hills  of  the  Rockies,  while  twelve  miles 
distant,  in  au  air-line,  the  summit  of  Pike's  Peak — brown  in  summer 
and  covered  with  snow  during  the  rest  of  the  year — rises  to  a  height 
of  14,134  feet  above  the  sea.  On  the  peak  there  is  a  stone  build- 
ing, formerly  occupied  as  a  signal-service  station,  and  now  used  as  a 
hotel,  and  the  cogwheel  railroad  carries  up  visitors  daily  during  the 
summer  season.  From  Colorado  Springs  to  the  southwest,  west,  and 
northwest  the  hills  rise  upward  of  4000  feet  above  the  town.  To 
the  north  and  northeast  are  high  mesas,  also  affording  protection  from 
winds  and  storms,  while  to  the  east  and  south  the  country  is  an 
open  plain,  rolling,  brown,  and  dry.  Even  so  small  a  distance  as 
separates  the  town  from  the  foot-hills  is  of  benefit  during  storms, 
for  a  heavy  downpour  is  often  seen  on  the  mountains  which  does 
not  reach  Colorado  Springs. 

The  rainy  months  are  from  April  to  August,  inclusive,  the  most 
protracted  season  being  usually  a  period  of  four  or  six  weeks  of 
daily  rains,  beginning  during  the  last  half  of  July.  In  the  moun- 
tains these  rains  are  more  severe,  but  on  the  plains  they  frequently 
amount  only  to  afternoon  thundershowers. 

The  total  yearly  rainfall  averages  14.46  inches;  of  this  the  nor- 
mal precipitation  is  11.18  inches  during  the  five  months  from  April 
to  August,  inclusive,  leaving  3.28  inches  to  fall  during  the  re- 
maining seven  months  from  September  to  March,  inclusive.  ''It 
therefore  follows  that  the  fall  of  snow  is  infrequent  and  scanty 
through  the  winter.^  By  reason  of  the  dryness  and  porosity  of  the 
soil  and  the  dryness  of  the  air,  with  the  warmth  of  almost  constant 
sunshine,  the  evaporation  of  snow  is  very  rapid.  In  looking  at  the 
temperature-record  it  will  be  noticed  that  once  or  more  during  the 
winter  the  temperature  drops  below  zero,  and  sometimes  a  long 
way  below.  Such  temperatures  rarely  last  throughout  the  day, 
as  the  sun  seldom  fails  to  shine.  When  such  cold  weather  occurs 
during  the  day  the  wind,  instead  of  taking  its  usual  daily  course 
from  north  to  south  through    the  eastern    quarter,  remains  in  the 

'  Owing  to  the  near  protection  of  the  mountains  on  the  west,  and  the  presence  of  the  Arkansas 
Divide,  twenty-five  miles  north,  which  breaks  the  force  of  the  northern  storms,  Colorado  Springs 
has  usually  lighter  winter  snowfalls  than  her  neighbors  which  have  a  more  exposed  position  on 
the  plains.  The  record  for  total  rainfall  and  snowfall  for  three  consecutive  winters  is  as  fol- 
lows : 

Denver.  Pueblo.  Colorado  Springs. 

1892-'93.  Nov.  to  May,  3.73  inches.  Nov.  to  May,  2.74  inches.  Jan.  to  May,  0.66  inch. 

1893-'94.     "     "      "      5.98     •■  "    "      "       3.21      "  Nov.  to  May,  1.46     " 

lS94-'9o.      "    "      "      4.09     "  "     "      "       3.57      "  -     "      "       2.25  Inches. 


ROCKY  MO UNTATy  BEGIOX.  255 

uorth,  but  has  a  small  s'elocity,  a  high  wind  and  low  tempera- 
ture being  rarely  in  conjunction.  On  these  exceptional  days  the 
younger  and  more  vigorous  invalids  go  out  to  exercise  with  benefit, 
but  those  who  are  more  delicate  remain  indoors,  bearing  their  cap- 
tivity with  grace,  as  something  that  occurs  to  them  only  three  or 
four  days  out  of  the  whole  winter.  Driving  is  most  agreeable  in  the 
morning,  as  there  is  usually  very  little  wind;  but  after  luncheon  a 
strong  breeze  from  the  southeast  is  not  uncommon,  making  walkiuc 
or  riding  more  pleasant."^ 

June  is  likely  to  be  one  of  the   most  suitable  of   the   summer- 
months  for  camping-out,  as  there  are  usually  several  weeks  of  dry, 
sunny  weather  before  the  coming  of  the  cooling  summer-rains. 
.  The  mornings  are  invariably  fine  during  the  entire  year,  and  are 
therefore  the  most  favorable  time  of  the  day  for  being  outdoors. 

A  few  hot  days  occur  during  the  summer,  but  the  nights  in  these 
high  altitudes  grow  rapidly  cooler  toward  morning.  ''The  absence 
of  dew  permits  all  but  the  most  delicate  invalids  to  sit  on  the  porches 
in  the  evening  with  enjoyment."" 

The  autumn  and  winter  are  delightful,  the  sun  usually  shining 
strong  and  clear  and  warm,  even  after  a  night  when  the  mercury 
has  dropped  pretty  low.  The  air  is  so  dry  in  winter  that  during 
the  "  invalid's  day  "  lasting  from  9  to  4  o'clock  the  temperature 
outdoors  in  the  sun  is  rarely  uncomfortable. 

''After  a  night  in  which  there  have  been  a  hard  frost  and  a  clear 
sky,  with  a  light  breeze  from  the  north,  and  duripg  which  the  in- 
valid has  usually  slept  soundly  under  several  blankets,  with  his 
window  partly  open,  he  awakes  to  find  the  sun  shining  into  his 
eastern  window.  And  this  is  a  feature  which,  whatever  the  weather 
may  be  later  in  the  day,  is  rarely  absent.  After  breakfast  our  invalid 
steps  into  the  street,  being  then  in  an  atmosphere  in  which  the  heat  in 
the  sun  is  92°  and  in  the  shade  30°  F.  A  gentle  air  is  stirring 
from  the  northeast  at  the  rate  of  six  miles  an  hour.  The  mean 
dew-point  is  18°. 

"As  the  day  proceeds  the  temperature  rises  to  its  highest  point, 
being  100°  in  the  sun  and  40°  in  the  shade  between  2  and  3  p.m., 
while  the  wind,  which  has  veered  rapidly  from  the  north  to  the 
south,  blows  with  its  highest  daily  velocity,  thirteen  miles  an 
hour.  After  2  p.m.  the  wind  works  back  again  toward  the  east, 
being  at  sundown  northeast,   and   continuing  as  darkness  falls  to 

1  An  Invalid's  Day  in  Colorado  Springs.    S.  E.  Solly,  M.D.  -  Ibid. 


256  MEDICAL  CLIMATOLOGY. 

shift  back  to  the  northern  quarter,  whence  it  blows  from  8  p.m.  to 
9  A.M.,  its  velocity  dropping  to  })etween  seven  and  eight  miles  an 
hour/  and  the  temperature  of  the  air  at  the  same  time  falling  from 
three  to  four  degrees.  The  ground  is  usually  bare  of  snow,  no  rain 
falls  from  mid-September  to  mid-April,  and  the  sun  shines  unob- 
structed by  clouds.  Duriug  the  three  winter  months  the  number 
of  cloudy  days  does  not  average  more  than  five  a  month.  The  effect 
of  such  an  air  is  bracing  and  genial,  and  being  so  dry  the  cold  in 
the  shade  is  very  little  felt,  a  medium-weight  wrap  being  all  that  is 
needed.  The  roads  are  good  and  seldom  obstructed  by  snow  or 
mud,  and  the  neigiil)oriug  hills  and  plains  are  full  of  interesting 
points  to  visit,  and  pleasant,  sheltered  nooks  where  the  invalid  can 
rest  under  the  agreeable  heat  of  the  sun  and  eat  his  midday  meal 
without  fear  of  taking  cold.  " 

The  very  cold  days  of  winter  (they  are  not  numerous)  and  the 
windy  days  of  spring  are  the  greatest  trials  for  an  invalid  at  Colo- 
rado Springs.  '^  The  spring  weather  in  Colorado,  as  in  most 
climates,  is  the  least  desirable  ;  during  late  March  and  early  April 
the  chief  part  of  the  snow  falls  and  the  wind  that  goes  mainly  to 
swell  the  total  of  the  annual  movement  occurs."^ 

The  night-air  is  cold  and  dry  all  the  year  round,  with  very  few 
exceptions.  Windows  can  be  left  open  on  the  coldest  nights,  as  the 
air  in  a  room  will  never  get  as  cold  as  the  air  outside,  and  the  colder 
the  air  is  the  less  moisture  it  contains.  Immunity  from  fog  is  proved 
by  the  low  dew-point,  the  yearly  average  dew-point  for  Colorado 
Springs  for  1893  being  24°. 

The  mean  daily  range  of  temperature  in  Colorado  Springs  is  25°, 
and  it  varies  but  little  from  that  average  for  every  month  in  the 
year. 

It  is  a  question  how  adversely  the  constant  and  wasteful  water- 
ing of  the  lawns  in  summer  affects  very  delicate  invalids  who 
spend  a  great  part  of  the  day  on  porches  exposed  to  such  influence. 
A  short  series  of  experiments  in  the  way  of  daily  observations  of 
the  relative  humidity,  taken  during  one  summer  by  means  of 
Mason's  hygrometer,  on  a  front  porch  over  a  lawn  that  was  not 
sprinkled  excessively,  showed  a  usual  variation  of  13  per  cent, 
increase  over  the  Government  observations,  which  were  taken 
forty-nine  feet  above  the  ground,  with  no  lawn  around  the  building. 

'  See,  also,  Wind-movement  in  Denver. 

-    A.n  Invalid's  Day  in  Colorado  Springs.    S.  E.  Solly,  M.D. 


ROOKY  MOUNTAIN  REGION.  257 

There  is  little  doubt  that  the  desire  for  fresh  grass  in  a  naturally 
arid  country  leads  to  a  questionable  freedom  in  the  use  of  water. 

Except  for  the  short-lived  objections  of  spring  winds  and  rains, 
August  raius,  and  winter  cold — none  of  which  periods  is  long  con- 
tinued— there  are  few  objections  to  Colorado  Springs  as  a  health- 
resort  for  those  who  are  not  affected  by  long-continued  residence 
at  a  considerable  altitude. 

On  the  other  hand,  it  possesses  advantages  such  as  few  other 
resorts  can  offer  :  a  dry,  porous  gravel-soil ;  unusually  wide  streets; 
town-sewerage  ;  remarkably  pure,  soft  mountain-water,  containing 
less  than  three  grains  of  total  solids  to  the  gallon;^  and  good  drives, 
beautiful  natural  scenery,  and  the  absence  of  manufactories. 

The  markets  are  surprisingly  good  in  Colorado  Springs.  The 
grocery,  provision,  and  fruit-stores  are  numerous  and  unusually 
well  supplied  for  a  town  of  this  size. 

There  are  few  opportunities  for  business,  but  Cripple  Creek — 
twenty  miles  west  in  an  air-line — has  grown  to  be  a  bustling 
mining-town  of  over  20,000  inhabitants.  It  is  quite  dependent 
on  Colorado  Springs  as  the  nearest  town  of  any  size,  and  the 
development  of  its  mines  has  brought  much  wealth  to  the  Springs. 

Colorado  Springs  has  sixteen  trunk-lines  of  railway  and  direct 
daily  communication  with  the  East  via  the  main  line  of  the  Chicago, 
Rock  Island  and  Pacific  Railroad  to  Chicago.^ 

The  monthly  mean  temperature  for  January  is  26°  F. ;  for  July, 
69° ;  for  the  year,  47°  (means  for  sixteen  years).    Average  annual  days 


1  The  town-water  of  Colorado  Springs  is  drawn  from  Lali:e  Moraine,  a  natural  basin  on  the 
shoulders  of  Pike's  Peak,  situated  above  the  timber-line.  It  is  fed  by  the  melted  snows  of  the 
summit,  seeped  through  granite  and  gravel.  The  water  is  unusually  pure  and  soft,  and  is 
probably  as  near  an  approach  to  distilled  water  as  any  public  water-system  could  furnish. 
The  supply  is  ample  for  a  town  several  times  the  present  size  of  Colorado  Springs.  The  last 
analysis  of  this  town-water  made  by  Prof.  William  Strieby,  of  Colorado  College,  showed  two 
and  one-half  grains  of  total  solids  to  the  gallon. 

-  As  Colorado  Springs  is  not  a  large  place,  it  may  be  useful  to  travellers  to  explain  its  railroad 
connections  : 

Passengers  from  the  East  have  a  through  sleeper  from  Chicago  to  Colorado  Springs  on  the 
Santa  Fe  and  the  Rock  Island  Railroads.  There  is  one  change  from  St.  Louis  on  those  roads. 
The  Missouri  Pacific  runs  a  through  sleeper  from  St.  Louis,  and  has  one  change  from  Chicago. 
Passengers  from  New  Orleans  or  Galveston  find  a  through  Pullman  running  from  Houston  to 
Denver  (Houston  is  one  and  one-half  hours  from  Galveston)  on  Union  Pacific,  Denver  and  Gulf 
Railroad. 

Passengers  from  California  come  over  the  Santa  Fe,  Colorado  Midland,  or  Denver  and  Rio 
Grande  Railroad  with  but  one  change. 

From  Oregon,  with  but  one  change,  over  Colorado  Midland  or  Denver  and  Rio  Grande  Rail- 
road. 

Chicago  to  Denver,  direct  through  sleeper  on  the  Burlington  Railroad,  one  change  to  Colorado 
Springs. 

17 


268 


MEDICAL  CLIMATOLOGY. 


above  90°,  7  (means  for  seven  years) ;  below  32°,  155.  Stormy 
days,  precipitation,  0.01  or  over,  69  (means  for  four  years).  Normal 
winter-rainfall,  0.7  inch.  J^fumber  of  cloudy  days  in  winter,  13; 
in  spring,  20;  summer,  13;  autumn,  11;  year,  57  days  (means  for 
six  years). 

The  annual  wind-movement  averages  9.1  miles  per  hour. 


Table  II.— Colorado  Springs.    Meaxs  for  Two  Years,  1893  and  1894. 


Temperature. 

Rela- 
tive 
humid- 
ity. 

Abso- 
lute 
humid- 
ity. 

Dew- 
point. 

Total. 

Month. 

Monthly. 

Extremes. 

Rain- 
fall. 

Cloudy 
days. 

Wind, 

hourly 

ve- 

Mean 

Max. 

Min. 

Max. 

Min. 

locity. 

(1894) 

(1894) 

Per  ct. 

Grains 

Inches. 

(1893) 

Miles. 

January, 

31° 

42° 

15° 

65° 

—2° 

44 

0.83 

9° 

0.01 

2 

11.1 

February, 

26 

36 

10 

56 

—3 

53 

0.80 

8 

0.36 

9 

10.7 

March, 

36 

50 

25 

72 

6 

46 

0.99 

13 

0.18 

7 

12.4 

April, 

44 

60 

32 

73 

11 

41 

1.16 

17 

0.38 

8 

12.5 

May, 

54 

68 

43 

81 

27 

48 

1.88 

29 

4.34 

10 

11.1 

June, 

63 

75 

48 

91 

38 

43 

2.27 

34 

2.17 

3 

10.0 

July, 

67 

78 

55 

90 

47 

52 

2.36 

45 

2.73 

8 

8.2 

August, 

64 

78 

52 

85 

42 

59 

2.45 

46 

2.22 

7 

7.2 

September, 

59 

72 

44 

82 

31 

43 

2.03 

31 

0.49 

2 

8.9 

October, 

48 

76 

14 

51 

1.61 

25 

0.45 

1 

9.1 

November, 

39 

67 

11 

71 

2 

44 

1.12 

16 

0.17 

5 

10.0 

December, 

32 

58 

2 

69 

-^ 

49 

0.99 

13 

0.22 

6 

9.6 

Annual, 

47 
29 



- 

91 

-7 

47 

1.48 

23 

13.72 

68 

10.0 

Winter, 

48 

0.87 

10 

0.59 

17 

10.4 

Spring, 

44 

45 

L26 

19 

4.92 

25 

12.0 

Summer, 

64 

51 

2.95 

41 

7.12 

18 

8.4 

Autumn, 

48 

46 

1.55 

24 

1.11 

8 

9.0 

Note.— The  maximum  temperature  for  1893  was  93°  on  one  day  in  June  and  one  day  in 
July.  For  1894  it  was  90°  on  one  day  in  June.  The  number  of  days  (or,  more  accurately  speak- 
ing, nights)  below  32°  during  1893  was  168.  The  minimum  temperature  for  1893  was  —3°  in 
February,  and  for  1894  —10°  in  January. 

The  month  of  October  is  missing  from  the  record  for  1894,  and  the  mean  for  six  years  is  used, 
except  in  cases  when  unattainable,  when  the  mean  for  October,  1893,  is  employed.  In  the 
seasonal  averages  no  difference  of  importance  will  be  perceptible. 

The  year  1893  was  a  dry  year,  and  the  year  1894  unusually  wet,  especially  in  May,  when  the 
precipiiation  was  7.34  inches.  The  mean  of  both  years  (13.72  inches)  is  nearly  one  inch  below 
the  normal  annual  precipitation  for  sixteen  years. 

The  wind-movement  for  1S93  was  unusually  high,  averaging  10.3  miles  per  hour  for  the  year, 
which  is  about  one  mile  per  hour  above  the  normal. 

The  year  1893  also  contained  an  unusual  number  of  cloudy  days.    (See  Table  V.) 


ROCKY  MO UNTAIN  REGION.  259 

The  summers  in  Colorado  Springs  are  usually  cool.  In  1892 
there  were  11  clays  when  the  thermometer  rose  above  90°,  the 
highest  point  being  94°;  in  1893  there  were  two  days  above  90°, 
the  highest  temperature  being  93°;  in  1894  a  temperature  of  90° 
was  reached  on  one  day  only  ;  in  1895  there  were  no  days  over 
90°,  the  highest  temperature  being  89°. 

In  the  warm  days  that  occur  in  Colorado  Springs  the  air  is  in- 
variably dry.  When  the  temperature  goes  above  85°  the  relative 
humidity  usually  drops  below  25  per  cent.,  and  the  "sensible" 
temperature  is  about  60°.  The  mean-  of  the  summer  minima  is 
51°,  showing  cool  nights. 

There  are  severe  wind-  or  dust-storms  at  infrequent  intervals  when 
the  air  is  very  dry  and  electrical.  They  are  exceedingly  disagreeable, 
but  do  not  occur  more  than  half  a  dozen  times  a  year,  and  the 
greatest  violence  of  the  wind  rarely  lasts  more  than  a  few  hours. 
The  gravel-soil  of  the  plain  on  which  the  town  of  Colorado  Springs 
stands  greatly  mitigates  tiiis  annoyance  as  compared  with  that  experi- 
enced in  towns  built  on  adobe-soil. 

Manitou  (elevation,  6300  feet;  population,  3000).  Five  miles 
west  of  the  town  of  Colorado  Springs,  in  a  sheltered  valley  at  the 
foot  of  the  mountains,  are  located  the  mineral  springs  which  give 
the  name  to  Colorado  Springs  and  form  one  of  the  principal  attrac- 
tions of  the  lively  hotel-resort  called  Manitou. 

Two  railroads,  a  line  of  electric  cars,  and  good  roads  for  driving 
connect  the  two  towns. 

There  are  eight  sparkling  soda  and  iron  springs,  varying  in  tem- 
perature from  44°  to  59°  F. — all  strongly  charged  with  carbonic 
acid  gas.  The  water  of  one  of  these — the  Navajo — is  bottled  in 
immense  quantities,  and  is  known  all  over  the  country  as  a  table- 
water  of  great  purity  and  value.  In  composition  and  taste  it  closely 
resembles  the  imported  Apollinaris  Water. 

A  half-mile  or  so  above  the  village,  situated  in  a  beautiful  canon, 
and  on  the  banks  of  Ruxton  Creek,  is  the  summer-house  over  the 
iron  Ute  Spring,  which  is  "  highly  effervescent,  of  the  temperature  of 
44.3°  F.,  and  very  agreeable  in  spite  of  its  marked  chalybeate  taste.  "^ 

Professor  O.  Loew,  Mineralogist  and  Chemist  of  the  Wheeler 
Expedition,  said  that  the  springs  of  Manitou  "  resemble  those  of 
Ems  and  excel  those  of  Spa." 

There  are  three  picturesque  canons  leading  into  the  mountains 

1  Manitou,  Colorado;  its  Mineral  Waters  and  Climate.    S.  E.  Solly,  M.D.,  1SS2. 


260 


MEDICAL  CLIMATOLOGY. 


from  Manitou — Ruxton,  or  Engleraan's  Canon,  William's  Canon, 
and  the  Ute  Pass,  the  latter  of  which  contains  the  old  Indian  trail 
through  the  apparently  impassable  range. 

Besides  the  cog-railway  to  the  summit  of  Pike's  Peak  there  is 
also  a  wagon-road. 

Manitou  has  a  number  of  good  hotels,  and  during  the  "  season," 
from  June  to  September,  they  are  usually  lively  with  visitors.  One 
or  two  keep  open  during  the  entire  year. 

The  climate  of  Manitou  differs  slightly  from  that  of  Colorado 
Springs.  The  valley  is  more  sheltered  from  the  winds,  but  is 
somewhat  damper  in  summer,  owing  partly  to  the  eifect  of  more 
frequent  mountain-rams  and  partly  to  the  presence  of  the  brooks 
that  flow  through  the  town.  The  days  in  winter  are  short,  on 
account  of  the  height  of  the  mountains  on  the  west.  During  the 
month  of  December  the  sun  sets  in  the  town  of  Manitou  a  few 
minutes  before  3  o'clock,  which  is  about  one  hour  and  a  quarter 
earlier  than  it  sets  in  Colorado  Springs. 


Analysis  of  the  Principal  Mineral  Springs  in  Manitou, 
Made  by  Dr.  Waller. 

In  a  pint  of  water  are  contained  grains  as  follows  : 


Ute 
Chief. 

Navajo 

Mani- 
tou. 

Hiawa- 
tha. 

Ute 
Iron. 

Little 
Chief. 

Sho- 
shone. 

Minnie- 
haha. 

Potassium  sulphate  . 

L949 

1.919 

1.336 

trace 

0.979 

0.501 

0.333 

trace 

Sodium  sulphate 

0.932 

1.367 

L268 

L880 

3.601 

2.601 

0.750 

Sodium  chloride 

3.346 

2.974 

2.193 

2.116 

3.333 

3.000 

LOOS 

Sodium  bicarbonate  . 

6.557 

5.326 

5.083 

4.271 

3.613 

1.114 

6.201 

1.666 

Calcium  bicarbonate 

10.477 

8.667 

8.635 

6.  023 

3.963 

5.251 

7.602 

2.801 

Magnesium  bicarbonate  . 

2.235 

2.005 

2.085 

0.092 

1.005 

1.001 

0.501 

Lithium  bicarbonate 

0.141 

0.089 

0.077 

0.092 

trace 

trace 

trace 

trace 

Iron  oxide  .... 

0.046 

0.003 

0.003 

0.031 

0.035 

0.125 

0.102 

SiUca 

0.467 

0.308 

0.312 

0.134 

0.452 

0.143 

trace 

trace 

Aluminum  .... 

0.015 

0.013 

0.009 

0.019 

Ferrous  carbonate    . 



0.049 

Strontium  carbonate . 

trace 

trace 

Potassium  chloride    . 

0.218 

Magnesium  sulphate 

L123 

Calcium  sulphate 

0.214 

Total       . 

26. 165 

22.671 

2L801 

12.193 

14.211 

15.069 

19.751 

6.823 

ROCKY  MO UNTAIN  REGION.  261 

The  Garden  of  the  Gods  is  situated  a  mile  or  two  from  Mauitou 
and  about  four  miles  from  Colorado  Springs.  This  imaginative 
title  is  applied  to  a  number  of  fantastic  rock-formations.  The  red 
sandstone  has  been  ground  by  a  mighty  agency  in  the  past  into 
strange  forms  resembling  with  an  accuracy  sometimes  grotesque  the 
shapes  of  animals  and  objects.  The  huge  rocks  at  the  gateway  are 
over  three  hundred  feet  high. 

Glen  Eyrie  and  Blair  Athol,  a  few  miles  further  north,  contain 
similar  freaks  of  nature. 

Broadmoor.  Four  miles  southwest  of  Colorado  Springs  is 
Cheyenne  Mountain,  which  guards  the  Broadmoor  Casino,  where, 
during  the  summer  season,  visitors  can  hear  good  music  and  cooling 
refreshments  can  be  obtained.  The  Broadmoor  Hotel,  a  well- 
equipped  building  fronting  on  the  grounds  of  the  Broadmoor  Casino, 
has  been  recently  finished. 

In  the  Cheyenne  Valley  are  a  number  of  charming  homes.  There 
are  also  several  summer-camps  and  a  few  boarding-houses,  where 
quarters  can  be  secured  all  the  year  round.  The  valley  is  sheltered 
from  the  wind  by  the  higher  land  rising  on  either  side. 

Not  far  from  Broadmoor  are  South  Cheyenne  Canon  and  the 
Seven  Falls,  North  Cheyenne  Canon,  and  still  further  north  Bear 
Creek  Canon,  through  which  the  first  Government  trail  to  Pike's 
Peak  was  constructed. 

A  few  miles  west  of  Manitou  are  a  number  of  attractive  summer- 
resorts,  rising  higher  in  altitude  as  the  railroad  steadily  climbs  around 
the  huge  shoulders  of  Pike's  Peak  to  reach  the  park-like  country 
beyond. 

Cascade  (7240  feet),  Ute  Park  (7500  feet).  Green  Mountain 
Falls  (7730  feet),  and  Woodland  Park  (8480  feet)  are  stations  on 
the  Colorado  Midland  Railroad,  between  eleven  and  twenty  miles 
from  Colorado  Springs. 

They  are  picturesque  resorts,  situated  in  canons  and  small  natural 
parks,  and  are  supplied  with  good  hotels.  Some  of  them  have 
also  accommodations  for  tent-  and  cottage-life. 

Manitou  Park  (elevation,  7800  feet)  is  a  green  valley  surrounded 
by  beautiful  mountains,  the  slopes  of  which  are  covered  with  pine- 
forests.  The  rides  and  drives  are  very  fine.  It  is  seven  miles  from 
Woodland  Park,  and  is  reached  by  a  stage  which  makes  daily  trips 
between  the  two  places  during  the  season.  There  is  a  comfortable 
hotel  surrounded  by  pleasant  cottages,  and  the  grounds  contain  golf- 


262  MEDICAL  CLIMATOLOGY. 

links,  tennis-courts,  abd  a  lake  which  affords  excellent  trout- 
fishiug. 

There  is  a  greater  summer  rainfall  ou  the  mountains  than  on 
the  plains,  the  showers  usually  occurring  during  the  afternoon/ 

Pueblo  (elevation,  4700  feet ;  population,  35,000).  It  is  best 
known  as  a  rising  manufacturing-city,  but  the  records  of  dryness 
and  fair,  mild  winters  entitle  it  to  consideration  among  the  health- 
resorts  of  the  Colorado  plains.  The  town  is  situated  on  both  sides 
of  the  Arkansas  River,  which  is  a  muddy,  rapid-flowing  stream. 
The  soil  in  the  lower  portion  of  the  city  is  adobe,  cakiug  to  the 
hardness  of  brick  under  the  hot  summer  sun,  dusty  under  the  in- 
fluence of  a  strong  wind,  muddy  and  tenacious  after  heavy  rain  or 
snow. 

From  late  September  to  March  the  weather  is  usually  all  that  can 
be  desired.  The  nearest  mountains  are  twenty-five  miles  away, 
and  the  lower  altitude  of  the  Arkansas  valley  insures  milder  weather 
than  that  found  further  north.  This  portion  of  the  year  is  a  season 
of  almost  perpetual  sunshine  and  moderate  temperature.  The  spring 
months  are  more  doubtful  on  account  of  occasional  dust-storms  and 
parching  winds.  The  summers  are  very  hot.  The  highest  tem- 
perature is  usually  about  10°  F.  above  that  at  Colorado  Springs. 
The  Pueblo  Board  of  Trade  report  for  1893  contains,  on  page  96, 
the  statement  that  "  wind-storms  are  unknown,  winter  or  summer." 
On  June  14,  1893 — one  of  the  days  this  report  was  being  sent 
through  the  mail — a  dust-storm  raged  in  Pueblo  about  sunset  for 
an  hour  or  more,  at  times  too  thick  to  see  through  it  a  church- 
steeple  at  a  distance  of  two  blocks.  Such  storms  are  infrequent, 
but  this  incident  illustrates  the  constant  allowance  that  must  be 
made  for  local  prejudice.  Regarding  the  heat,  the  average  number 
of  days  over  95°  during  five  years  is  16  for  each  year,  showing  a 
high  general  temperature  for  the  impaired  vitality  of  invalids  to 
withstand.  A  visiting  physician  writes:  "  Pueblo  is  several  degrees 
warmer  than  either  of  the  other  cities  visited  (Denver  and  Colorado 
Springs).  In  fact,  it  was  hotter  than  any  place  in  New  Mexico 
when  I  was  there.  Except  for  the  smelters  already  noticed,  it  is  a 
good  health-point  for  those  with  weak  lungs.""  If  Pueblo  is  to  be 
entirely  a  manufacturing-city,  the  smoke-nuisance  should  be  care- 
fully considered  by  delicate  visitors,  who  should  select  a  place  of 

1  See  Climate  of  Colorado.  -  Dr.  W.  P.  Roberts,  in  Health  Journal. 


ROCKY  MOUNTAIN  REGION. 


263 


residence  as  far  from  the  noxious  outpourings  of  chimneys  as  pos- 
sible. The  water-supply  of  the  town  is  drawn  from  the  Arkansas 
Riv^er,  the  water  of  which  is  alkaline  and  contains  considerable 
muddy  sediment.  There  are  artesian  springs  of  good  quality,  but 
settling  basins  for  the  north  side  water-system  should  be  provided 
to  clear  and  purify  the  regular  river-supply  for  domestic  use. 

Pueblo  has  good  stores,  banks,  and  churches.  There  is  one  good 
hotel,  and  others  are  contemplated.  There  is  a  pleasant  social  club, 
and  the  Opera  House  is  one  of  the  finest  buildings  of  its  kind  in  the 
State. 

The  average  mean  temperature  for  January  is  29°  F.;  for  July,  76°; 
for  the  year,  52°  (from  records  for  fifteen  years).  Average  number 
of  days  above  90°,  41;  below  32°,  146;  cloudy  days,  53;  stormy, 
52  (from  records  for  four  and  six  years).  The  average  annual 
velocity  of  the  wind  is  7.4  miles  per  hour. 

In  1892  the  number  of  days  on  which  there  were  gales  (wind 
over  40  miles  an  hour)  was  (for  Pueblo)  19  days. 

Two  of  the  artesian  wells  in  Pueblo  yield  water  of  remarkable 
qualities.  In  one  the  water  contains  a  large  amount  of  lithium 
salts.  Tub-baths  are  given  at  the  hotel  adjoining  the  spring, 
which  in  every  way  offers  good  accommodations.  The  water  flows 
from  a  depth  of  1200  feet.  An  analysis  made  by  Professor  A.  A. 
Cunningham,  of  the  University  of  California,  follows: 


. 

Grains  per  U.  S.  gallon 

Lithium  bicarbonate 

.       7.81 

Lithium  sulphate       ..... 

.       1.92 

Magnesium  sulphate  ..... 

.     60.47 

Magnesium  carbonate         .... 

.       4.71 

Iron  carbonate   ...... 

.       4.14 

Potassium  chloride 

.      8.83 

Calcium  sulphate        ..... 

.     14.79 

Calcium  carbonate 

.     15.12 

Sodium  sulphate 

.     12.41 

Sodium  chloride         ..... 

.     19.72 

Phosphoric  acid          ..... 

trace 

Organic  matter  ....•• 

.     none 

Total  solids 

.  149.92 

The  other  well  furnishes  a  sulphurous  chalybeate  water,  flowing 
from  a  depth  of  1400  feet,  which  is  extensively  used  for  bathing.  It 
is  called  a  "  INIagnetic  Mineral  Spring."     A  circular  issued  by  the 


264 


MEDICAL  CLIMA  TOL  0 G  Y. 


proprietor  states  that  ''a  qualitative  analysis  of  the  water  gives  the 
following  constituents  : 

''Sulphuretted  hydrogen,  iron  (form  titanic  acid),  bicarbonate  of 
lime,  sulphate  of  soda,  sulphate  of  magnesia,  manganese,  potassium 
(trace),  sulphuric  acid,  arsenious  acid(?).  One  remarkable  peculi- 
arity of  the  water  is  that  knives  are  readily  magnetized  by  holding 
them  in  the  water." 

No  quantitative  analysis  of  this  water  has  been  published. 

Beulah,  twenty-eight  miles  from  Pueblo,  is  a  resort  at  an  eleva- 
tion of  5600  feet,  situated  in  a  basin  along  the  foot-hills  on  the 
eastern  slope  of  the  Greenhorn  range.  It  is  reached  by  regular  stage 
in  about  five  hoars.  The  village  has  a  population  of  200.  There 
is  a  good  hotel.  Board  can  also  be  secured  at  some  of  the  ranches. 
Water  is  obtained  from  the  mountain-streams.  There  are  canons 
and  other  places  of  interest  to  visitors.  The  Beulah  Springs  are 
mild  soda  springs  of  excellent  quality. 

Fifteen  miles  west  from  Pueblo  is  the  Carlile  Soda  Spring,  which 
is  carbonated  and  put  on  the  market. 

An  analysis  made  by  T.  A.  Stoddard,  M.D.,  of  Pueblo,  is  as 
follows  : 

Grains  in  U.  S.  gallon. 


Sodic  carbonate 

9.33 

Calcic  carbonate 

18.56 

Magnesium  carbonate 

11.60 

Ferric  carbonate 

0.58 

Potassic  sulphate 

1.16 

Sodic  sulphate    . 

23,20 

Sodic  chloride    . 

8.70 

Calcic  phosphate 

1.50 

Sodic  phosphate 

0.87 

Silica 

trace 

Total 

5olids 

75.50 

Canon  City  (elevation,  5300  feet ;  population,  3800).  Canon 
City  is  situated  in  a  valley  near  the  entrance  to  the  Arkansas 
Caiion.  The  town  lies  mainly  on  the  north  side  of  the  Arkansas 
River.  It  is  forty-five  miles  northwest  of  Pueblo,  on  the  main 
line  of  the  Denver  and  Rio  Grande  Railroad  and  on  a  branch  line 
of  the  Santa  Fe  Railroad  from  Pueblo.  It  has  a  milder  winter 
climate  than  the  cities  on  the  plains.  This  is  due  largely  to  the 
shelter  from  the  wind  afforded  by  the  surrounding  mountains,  which 
rise  2000  or  3000  feet  above  the  town  and  protect  it  on  the  north 


ROCKY  MOUNTAIN  REGION. 


265 


and  south.  A  westerly  wind  blows  occasionally  through  the  canon, 
but  its  force  is  principally  felt  south  of  the  river.  To  the  east — or 
a  little  south  of  east — the  valley  opens  to  the  plains.  Snow  seldom 
falls  and  quickly  disappears. 

The  soil  of  the  valley  is  adobe.  There  is  a  small  residence- 
district  south  of  the  river  where  the  soil  is  more  sandy.  The  town 
is  supplied  with  electric  lights,  waterworks,  and  a  system  of  sewer- 
age. The  waterworks  are  artesian  wells  sunk  near  the  Arkansas 
River,  on  the  Holly  system,  into  which  the  river-water  filters.  It 
is  good  water,  but  hard. 

Caiion  City  has  a  number  of  comfortable-looking  residences,  each 
house  being  built  usually  of  brick  and  standing  alone  on  its  own 
lot  of  land.     The  residence-streets  are  well  shaded. 

There  are  two  or  three  fair  hotels  and  a  few  boarding-houses. 

About  three-quarters  of  a  mile  west  of  the  postoffice  are  the  two 
cold  soda  springs,  one  of  Avhich  has  slight  traces  of  iron.  Half  a 
mile  further  are  the  hot  springs,  where  there  are  a  hotel  and  a  bath- 
house. 

The  analysis  of  these  mineral  springs  by  Professor  Loew  is 
appended  : 

Analysis  of  Mineral  Springs,  Canon  City. 


Iron  Duke. 

Little  Ute. 

Ojocallente. 

Cold. 

Cold. 

Hot,  temp.  102°. 

Sodium  chloride. 

.      83.0 

118.0 

18.2 

Sodium  sulphate 

.      12.2 

12.1 

79.3 

Sodium  carbonate 

.     76.8 

76.4 

73.2 

Calcium  carbonate 

.     33.0 

22.5 

33.5 

Magnesium  carbonate 

.     14.6 

14.0 

12.8 

Iron     .... 

.     traces 

traces 

Lithia 

.     traces 

traces 

traces 

Grains  in  one  gallon  219.6  243.9  217.0 

The  valley  in  which  the  town  of  Canon  is  situated  is  famed  for 
its  strawberries,  grapes,  and  apples.  The  latter  fruit  is  extensively 
cultivated  with  the  aid  of  irrigation-ditches. 

The  attractions  in  the  neighborhood  are  the  Royal  Gorge  (which 
begins  within  two  miles  of  the  town,  but  which  requires  a  twelve- 
mile  drive  to  be  fully  appreciated) ;  the  Saurian  bone-fields  ;  the 
Marble  Caves  (twelve  miles) ;  the  Bottle  Rocks  ;  the  Bottomless  Pit; 
and  Grape  Creek  Canon  (distant  about  two  miles). 

The  State  Penitentiary  is  located  on  the  edge  of  the  town,  about 
half  a  mile  west  of  the  postoffice. 


266  MEDICAL  CLIMATOLOGY. 

Directly  south  of  the  town  is  a  large  zinc,  lead,  and  copper 
smelter,  the  smoke  from  which  is  usually  carried  away  from  the 
business-centre  and  residence-district  by  the  prevailing  winds. 

An  abstract  of  the  temperature-record  for  Canon  City  for  four 
years  is  as  follows:  mean  temperature  for  January,  32°  F,;  for  July, 
74°;  for  the  year,  53°.  The  minimum  for  January  is  — 6°  and  the 
maxima  for  July  and  August  100°.  By  seasons  the  temperature 
and  rainfall  are  as  follows: 


Winter. 

Spring. 

Summer. 

Autumn. 

Temperature,  four  years,     34° 

52° 

72° 

53° 

Rainfall,  six  years,           1.80  ia. 

4.24  in. 

4.21  in. 

1.63  in, 

The  mean  of  the  annual  rainfall  for  six  years  is  11.38  inches. 
The  year  1894  had  an  excessive  rainfall,  its  total  being  15.96  inches. 

There  are  no  records  of  the  relative  humidity,  but  it  is  about  the 
same  as  Pueblo,  perhaps  a  little  higher  in  summer  on  account  of 
the  irrigation  aud  the  absence  of  strong  winds. 

Glenwood  Springs  (elevation,  5200  feet ;  population,  1500). 
A  little  Avest  of  the  centre  of  the  State  of  Colorado,  not  far  beyond 
Leadville  (10,200  feet),  is  the  crest  of  the  great  Continental  Divide. 
Glenwood  Springs  is  on  its  western  slope,  and  the  waters  of  the 
Roaring  Fork  and  the  Grand  River,  which  meet  opposite  the 
town,  find  their  way  eventually  into  the  Pacific  Ocean. 

The  town  is  reached  by  the  Denver  and  Rio  Grande  and  Colorado 
Midland  Railroads. 

The  principal  attraction  is  the  famous  Yampa  Hot  Spring,  which 
flows  the  enormous  quantity  of  2000  gallons  per  minute,  at  a  tem- 
perature of  124°  F.  A  large  and  complete  bath-house  has  been 
built  to  utilize  this  hot  saline  water  under  medical  direction.  There 
are  also  sulphurous  vapor  caves  and  an  open  swimming-pool  700 
feet  in  length  by  100  feet  in  width,  where  outdoor  baths  may  be 
enjoyed  during  the  entire  year. 

Glenwood  Springs  has  one  of  the  finest  hotels  in  the  West.  It  is 
a  large  building  in  the  Italian  style  of  architecture,  constructed  of 
Colorado  peachblow  colored  stone  and  Roman  brick.  It  surrounds 
an  open  court  which  is  terraced,  and  has  grass-plats,  fountains, 
and  beds  of  flowers.  The  hotel  has  200  guest-rooms;  it  is  well 
heated,  liberally  supplied  with  open  fireplaces,  and  is  lighted  by 
electricity. 

Glenwood  Springs  has  an  ample  water-supply,  and  sewers  in  the 
populous  section. 


ROCKY  MOUNTAIN  REGION. 


267 


The  meteorological  record  for  Glenwood  Springs  is  incomplete. 
It  is  only  possible  to  obtain  a  record  of  the  temperature  for  two 
full  years,  and  of  the  rainfall  for  three  full  years,  which,  given  by 
seasons,  are  as  follows: 

Winter.         Spring.       Summer.       Autumn.        Year. 
Monthly  mean  ) 
temperature,  }  27°  50°  69°  47°  48° 

Rainfall  (total),  4.90  in.      3.04  in.     3.80  in.     4.22  in.     15.96  in. 
Monthly  mean  temperature  for  January  (two  years)    .     22° 
Monthly  mean  temperature  for  July  (two  years) .         .     72 
Mean  yearly  minimum  (three  years)     ....  — 5 
Mean  yearly  maximum  (three  years)    ....  100 

Analysis    of  the  Yampa  Springs  (Glenwood  Springs,   Colorado) 
(made  by  C.  F.  Chandler,  Ph.D.,  June,  1888).    Temperature  124°  F. 

Grains  in  tJ.  S.  gallon  of 
231  cubic  inches  of  water. 
1089.83 
13.09 
0.56 
trace 


Sodium  chloride 
Magnesium  chloride 
Sodium  bromide 
Sodium  iodide  . 
Calcium  fluoride 
Potassium  sulphate 
Calcium  sulphate 
Lithium  bicarbonate 
Magnesium  bicarbonate 
Calcium  bicarbonate 
Iron  bicarbonate 
Sodium  biborate 
Sodium  phosphate    . 
Alumina   . 
Silica 
Organic  matter 

Total 


trace 
24.04 
92.38 

0.22 
13.55 
24.37 
trace 
trace 
trace 
trace 

1.97 
trace 

1250.04 


Steamboat  Springs  (elevation,  6800  feet)  is  one  hundred  miles 
south  of  Rawlins,  Wyoming,  on  the  Union  Pacific  Railroad,  and 
eighty-five  miles  northwest  from  Hot  Sulphur  Springs,  Middle 
Park,  Col.  Leaving  the  Denver  and  Rio  Grande  Railroad  at  Wol- 
cott,  the  tourist  fiirst  goes  by  stage  to  McCoy's,  distant  twenty-two 
miles  to  the  north.  From  there  a  stage  can  be  taken  the  next 
morning  at  6  a.m.  for  Steamboat  Springs,  sixty  miles  further  north. 
This  part  of  the  ride  occupies  about  twelve  hours. 

The  road  goes  through  Egeria  Park,  which  is  noted  for  its 
lovely  scenery.      Elk,  deer,  antelope,  bear,  and  mountain-sheep  are 


268  MEDICAL  CLIMATOLOGY. 

said  to  be  fairly   plentiful  on   tbe  mountains  in  this   vicinity,  and 
the  best  trout  and  grayling  fishing  in  the  State  is  found  between 
Zarapa  (formerly    Egeria)  and  Steamboat  Springs,    on  the  Bear 
River. 

The  town  of  Steamboat  Springs  has  about  400  inhabitants.  It  is 
situated  in  a  narrow  valley  surrounded  by  mountains.  Within  a 
radius  of  two  miles  from  the  centre  of  the  town  there  are  over  300 
springs,  of  which  more  than  60  are  known  to  contain  soda,  magnesia, 
sulphur,  aud  iron.  Some  of  the  cold,  sparkling  waters  are  very 
palatable,  noticeably  those  of  the  Iron  Spring.  They  vary  in 
temperature  from  cold  to  156°  F,  Many  of  the  hot  springs  send 
off  clouds  of  steam,  which  are  particularly  noticeable  on  a  cold 
morning. 

There  is  no  detailed  weather-record  for  Steamboat  Springs.  It  is 
on  the  western  slope  of  the  Continental  Divide,  and  has  a  larger 
rainfall  and  snowfall  than  many  localities  further  south  in  the 
State.  It  is  a  beautiful  place  for  camping-out  and  hunting  during 
the  summer  and  early  autumn.  The  value  of  the  hot  springs  is 
very  great,  and  it  would  be  considered  a  marvellous  resort  if  it 
were  more  accessible  and  better  known. 

The  mean  record  of  rainfall  for  Steamboat  Springs  for  three  years 
is  as  follows  :  winter,  9.30  inches  (including  melted  snow) ;  spring, 
6.03  inches;  summer,  0.85  inch;  autumn,  3.11  inches.  Total 
annual,  19.29  inches. 

The  mean  monthly  temperature  at  Steamboat  Springs  in  1893 
by  seasons  was  as  follows:  winter,  19°;  spring,  37°;  summer,  59°; 
autumn,  44°;  year,  40°.  Monthly  mean  for  January,  16°;  for  July,, 
61°.  Maximum,  91°.  The  minimum  temperature  was  below  32° 
every  month  in  the  year. 

Grand  Junction  (elevation,  4500  feet;  population,  2500).  The 
town  of  Grand  Junction,  which  is  on  the  Denver  and  Rio  Grande 
and  Colorado  Midland  Railroads,  lies  in  a  valley  fifteen  miles  long, 
opposite  the  junction  of  the  Gunnison  and  Grand  Rivers.  It  is 
a  busy  town  in  the  centre  of  what  will  probibly  be  in  time  the 
greatest  fruit-growing  region  of  Colorado — .■  re  moderate  altitude, 
adobe  soil,  shelter  from  heavy  winds  and  storms,  and  ample  supply 
of  water  for  irrigation  all  contributing  to  that  result.  All  decidu- 
ous fruits  flourish  in  the  valley,  but  it  is  especially  noted  for  its  fine 
peaches. 

Like  Glenw'  ^d  Springs,  Grand  Junction  is  on  the  Pacific  slope, 


ROCKY  MOUNTAIN  REGION.  269 

west  of  the  Continental  Divide,  which  is  crossed  at  an  elevation  of 
over  10,000  feet  on  the  Denver  and  Kio  Grande  Railroad,  and  on 
the  Colorado  Midland  Railroad  at  an  elevation  of  11,500  feet. 
There  is  no  complete  weather-reeord.  The  mean  temperature  for 
two  years  (1893-'94)  by  seasons  was  as  follows  :  winter,  31°;  spring, 
52°;  summer,  75°;  autumn,  52°;  for  the  year  53°.  The  minimum 
temperature  in  1894  was  3°;  maximum,  100°. 

The  rainfall  of  the  valley  is  very  low,  the  annual  mean  for  five 
years  being  8.45  inches,  divided  as  follows:  winter,  1.88;  spring, 
2.38;  summer,  1.97;  autumn,  2.22  inches. 

The  annual  snowfall  is  34  inches  (in  Colorado  equal  to  about  3 
inches  of  rainfall),  of  which  nearly  19  inches  fall  in  February. 
Snow  seldom  remains  on  the  ground  for  any  length  of  time.  The 
wind-movement  is  small,  although  an  occasional  lively  wind-storm 
blows  through  the  valley. 

The  town-supply  of  water  for  domestic  purposes  in  Grand  Junc- 
tion is  taken  from  Grand  River,  and  is  poor.  An  appropriation 
has  recently  been  made,  however,  for  the  construction  of  a  pipe- 
line from  the  mountains,  which  will  furnish  pure  water.  There 
are  no  sewers. 

The  valley  has  mild  winters,  the  thermometer  seldom  reaching 
zero.  The  summers  are  hot.  When  it  was  an  arid  plain  the 
humidity  was  low.  How  far  the  universal  soaking  of  the  soil  by 
means  of  irrigation  will  affect  it  as  a  resort  for  pulmonary  invalids 
remains  to  be  seen.  During  the  winter  months,  however,  this 
objection  does  not  exist. 

Springs. 

Colorado  is  favored  with  a  great  number  of  mineral  springs,  the 
value  of  which  is  known;  but  it  may  be  said  now,  as  it  was  said 
several  years  ago,  "  it  is  impossible  to  do  full  justice  to  the  curative 
properties  of  the  whole  number,  as  but  a  small  portion  has  as  yet 
been  subjected  to  quantitative  analysis  and  few  have  been  tested 
as  to  the  effect  of  thnr  medicinal  qualities  upon  diseases." 

The  best  known  •'<.  "^  these  resorts  are  Manitou  and  Glenwood, 
where  villages  have  sprung  up  around  the  springs,  and  there  are 
first-class  hotels. 

The  Siloam  Springs  (6000  feet)  are  in  the  centre  of  a  beautiful 
valley  on  the  Grand  River  above  Glenwood  Springs,  on  the  line  of 
the  Denver  and  Rio  Grande  Railroad. 


270  MEDICAL  CLIMATOLOGY. 

The  springs  range  in  temperature  from  94°  to  104°,  and  are  said 
to  resemble  the  combination  of  saline  waters  found  at  Saratoga.^ 
The  total  flow  is  about  10,000  gallons  per  hour.  They  are  similar 
to  those  at  Glenwood,  and  can  be  used  in  the  vapor-caves  and  in  an 
open  pool  one  hundred  feet  in  diameter. 

The  Seltzer  Springs  at  Springdale,  ten  miles  from  the  town  of 
Boulder,  are  situated  near  the  edge  of  James  Creek,  surrounded  by 
wooded  mountains  and  in  the  midst  of  picturesque  scenery.  They 
are  reached  by  stage  from  Boulder.  A  small  hotel  has  been  erected 
near  the  springs. 

Idaho  Springs  (elevation,  7700  feet ;  population,  2000)  is  thirty- 
five  miles  west  of  Denver,  on  the  Colorado  Central  Eailroad,  a 
branch  of  the  Union  Pacific  Railroad.  The  town  is  situated  in  the 
Clear  Creek  Caiion,  and  is  reached  through  picturesque  scenery  ; 
on  account  of  its  accessibility  from  the  plains  it  promises  to  become 
eventually  a  desirable  retreat  for  invalids. 

The  mountains  on  the  north  protect  the  town  from  inclement 
winds,  ''while  the  less  precipitous  mountains  to  the  south  allow  a 
desirable  long  continuance  of  sun-exposure." 

There  are  several  hotels  and  boarding-houses. 

There  are  a  number  of  warm  springs,  and  hot  springs  with  a 
temperature  of  110°  to  120°  F.  A  little  further  up  the  valley  are 
the  Cave  and  Tunnel  Springs  and  bathing-pool. 

The  town  of  Idaho  Springs  is  supplied  ^^ith  pure  water  from 
mountain-springs. 

The  soil  is  sandy  and  porous. 

The  mean  temperature  for  winter  for  five  years  is  28°,  with  over 
2  inches  of  melted  snow,  falling  on  20  stormy  days.  Relative 
humidity  for  winter,  50  per  cent.  The  minimum  temperature  in 
1892  was  —14°. 

The  mean  temperature  for  spring  is  40°.  Total  precipitation  3 
or  4  inches,  and  cloudiness  about  the  same  as  for  winter,  with  per- 
haps more  stormy  days. 

The  mean  temperature  for  summer  is  62°;  relative  humidity,  50 
per  cent.  Rainfall  about  7  inches.  About  36  cloudy  days.  The 
summer-showers  are  usually  hard  and  brief.  The  water  is  quickly 
drained  away. 

The  mean  temperature  for  autumn  is  44°.  Rainfall  from  2  to  3 
inches  on  15  days, 

'  Mineral  Springs  of  Colorado.    C.  Denison,  M.D.,  18S9. 


R  0  CK  Y  MO  UN  TAIN  REGION.  271 

The  remarkable  Steamboat  Springs  are  referred  to  on  page  267. 

In  Middle  Park  are  the  Hot  Sulphur  Springs,  previously  men- 
tioned, situated  on  the  banks  of  the  Grand  River.  It  is  a  delight- 
ful region  for  camping-out.  In  a  basin,  bounded  by  peaks  of  the 
snow}-  range,  southwest,  and  high  up  among  the  mountains,  are 
effervescing  soda  springs,  not  yet  improved. 

In  South  Park  are  Hartzell's  Hot  Sulphur  Sprmgs  and  the 
South  Park  Springs,  saline  alkaline  waters,  on  the  bank  of  the 
South  Platte  River.  There  are  also  other  undeveloped  chalybeate 
and  alkaline  or  sulphur  springs  in  the  vicinity. 

In  the  small  valley  occupied  by  Caiion  (Jity  are  several  hot  and 
cold  springs,  chalybeate,  sulphur,  and  soda,  some  of  which  have 
been  improved.     (See  Canon  City.) 

South  of  Canon  City  sixty  miles,  in  Poucha  Pass,  are  the  Poncha 
Springs  (7480  feet),  a  collection  of  hot  and  cold  waters.  There  are 
thirteen  hot  springs  at  a  temperature  of  120°  F.,  with  sulphur  and 
soda  as  the  principal  constituents. 

Twenty  or  thirty  miles  north  of  Poncha  Pass,  situated  in  the 
Arkansas  Valley,  at  an  elevation  of  8000  feet,  are  the  Chalk  Creek 
Springs,  twelve  or  more  in  number,  at  various  temperatures,  the 
hottest  being  150°  F. 

The  Pagosa  Springs  (7100  feet)  lie  in  a  picturesque  country  on 
the  northern  bank  of  the  San  Juan  River  These  are  purgative 
alkaline  waters,  with  a  large  excess  of  sulphate  of  sodium,  and  they 
rise  to  a  temperature  of  140°. 

In  Wagon  Wheel  Gap  (8500  feet)  are  purgative  and  alkaline 
hot  springs  of  great  local  reputation,  while  near  Canon  Creek  and 
Uncompahgre  are  great  numbers  of  mineral  springs,  varying  in 
temperature  from  120°  to  140°  F. 

An  analysis  of  the  Colorado  Carlsbad  Spring  will  be  found  on 
page  253,  and  of  two  mineral  artesian  wells  in  Pueblo,  the  lithia 
water  and  the  suphurous  chalybeate  "magnetic"  water,  page  263. 

Utah. 

Salt  Lake  City  (elevation,  4300  feet;  population,  70,000).  It 
is  about  ten  miles  from  the  northwest  corner  of  the  city  to  the  shores 
of  the  Great  Salt  Lake.^     Some  of  the  popular  bathing-beaches  are 

1  The  Great  Salt  Lake  (elevation,  4200  feet)  is  about  80  miles  long  Ijy  80  or  40  miles  wide, 
covering  an  area  of  2360  square  miles.  It  has  an  average  depth  of  12  feet,  with  about  60  feet  as 
its  greatest  depth.  It  has  no  outlet.  The  last  analysis  of  the  water  showed  16.88  grains  of 
mineral  ingredients  in  one  U.  S.  gallon,  which  is  about  five  times  as  salt  as  the  .\tlantic  Ocean. 


272  MEDICAL  CLIMATOLOGY. 

a  little  more  distant.  Away  to  the  east  and  north  are  the  Wasatch, 
and  to  the  west  theOquirrh  range  of  mountains,  distant  about  twelve 
miles. 

The  streets  of  Salt  Lake  City  are  wide,  and,  except  in  the  active 
busineirs-centre,  well  shaded  with  trees.  In  the  business  portions 
of  the  city  most  of  the  streets  are  paved.  There  are  large,  well- 
equipped  stores  and  several  good  modern  hotels.  The  city  has  an 
excellent  service  of  electric  street-cars. 

Water  for  domestic  purposes  is  brought  from  the  mouutains.  It 
is  pure,  but  hard.  Ditches  along  the  sides  of  the  streets  carry  the 
water  for  irrigation.  In  the  residence  portion  of  the  town  are 
well-kept  lawns.     The  soil  is  adobe. 

There  is  a  town-system  of  sewers. 

Salt  Lake  City  is  one  of  the  three  Western  cities  of  good  size 
possible  for  the  residence  of  those  to  whom  a  sunny  climate  is 
necessary  and  who  desire  to  settle  in  an  active  business-centre. 
The  other  two  large  cities  are  Denver,  which  shares  Avith  Salt  Lake 
City  the  advantage  of  altitude,  and  Los  Angeles,  which  is  equally 
sunny  but  exposed  to  ocean-influence. 

Salt  Lake  City  is  accessible  by  rail.  Its  moderate  elev^ation  is  a 
point  worthy  of  consideration  by  a  certain  class  of  invalids. 

On  some  of  the  higher  benches  or  mesas  near  the  town  desirable 
situations  for  residence  can  be  found.  It  is  important  for  invalids 
in  all  large  cities  to  be  at  a  safe  distance  from  any  possible  ill-effects 
from  the  chimneys  of  manufactories  or  smelters. 

The  proximity  of  the  caiions  and  mountains,  the  hot  springs,  and 
the  immense  inland  sea,  with  its  bathing-resorts,  give  Salt  Lake  City 
unusual  facilities  either  as  a  temporary  resort  during  the  summer  and 
autumn  or  as  an  attractive  place  for  a  permanent  residence. 

Compared  with  some  of  the  other  high-altitude  weather-stations. 
Salt  Lake  City  has  a  somcNvhat  capricious  climate.  This  may  be 
partly  attributed  to  its  being  situated  west  of  the  Continental  Divide, 
and  therefore  more  directly  subject  to  the  far-reaching  Pacific  coast 
influence  than  localities  like  Denver  and  Colorado  Springs,  which  are 
on  the  eastern  slope  and  have  the  protection,  on  the  west,  of  the 
great  ranges  of  the  Rocky  Mountains. 

While  the  Government-records  show  it  to  be  very  dry  in  summer, 
it  is  also  exceedingly  hot.  In  the  autumn  it  is  moist  compared 
with  other  cities  on  the  plains,  and  in  the  winter  it  is  colder  and 
more  stormy,  judged  by  the  same  standard.     The  lowest  record  of 


ROCKY  MOUNTAIN  REGION.  273 

temperature  is  20°  below  zero,  in  January,  1883.  The  mean  tem- 
perature for  the  month  of  January  is  27°  ;  for  July,  76°;  for  the 
year,  51°. 

Average  number  of  days  above  90°,  30;  below  32°,  109.  The 
annual  mean  of  cloudy  days  is  88  ;  stormy  days,  81  (means  for  six 
years).  Rainfall  18.9  inches  a  year  (from  records  for  eighteen 
years),  of  which  5J  inches  is  the  average  rainfall  for  the  winter. 

The  wind-movement  throughout  the  year  is  moderate,  being  about 
five  miles  per  hour. 

New  Mexico. 

In  going  from  Colorado  into  New  Mexico  by  rail  the  change  of 
climate  is  noticeable.  The  traveller  passes  from  the  cool  air  of  the 
northern  side  of  the  Raton  range,  in  Colorado,  and  after  a  glimpse 
of  the  Spanish  peaks  crosses  the  State-line,  plunging  at  once  into 
the  blackness  of  a  half-mile  of  tunnel,  which  pierces  the  mountains 
at  an  elevation  of  7600  feet.  From  this  he  emerges  on  to  the 
sunny,  southern  slope  of  the  range,  where  it  seems  perceptibly 
warmer  and  brighter  than  on  the  other  more  shaded  side.  It  is  a 
milder  air,  certainly,  and  bears  promise  of  long,  sunny  winter-days 
and  freedom  from  snows. 

Topographically,  New  Mexico  is  a  high  plain,  called  by  the  Span- 
iards "  mesa  "  or  table-land.  At  Santa  Fe  this  plateau  rises  to  7000 
feet,  while  in  the  Lower  Pecos  Valley  it  is  depressed  to  about  3500 
feet  above  sea-level. 

The  Mesilla  Valley,  forty  miles  above  El  Paso,  lias  about  the 
same  elevation,  from  which  the  land  rises  to  the  northwest  and 
north.  The  average  elevation  of  the  State  is  probably  not  far  from 
5000  feet.  The  great  size  of  these  far  Western  States  has  always  to 
be  borne  in  mind  in  dealing  with  their  peculiarities.  In  this  brief 
summary  it  is  not  proposed  to  treat  of  New  Mexico's  entire  390 
miles  of  length,  but  only  of  those  portions  of  the  State  suitable  for 
the  residence  of  invalids,  so  far  as  they  are  known. 

The  rainfall  for  the  year  1891  (which  was  evidently  a  rainy  year) 
varied  from  4.55  inches  at  Demiug  to  32.83  inches  at  Chama.  The 
general  average  for  the  State  is  13^  inches,  with,  of  course,  a  quan- 
tity as  large  again  falling  on  the  mountain-summits,  principally  in 
the  form  of  snow.  In  New  Mexico  there  are  several  ^' islands  of 
greater  rainfall,"  where  a  much   heavier  precipitation  may  be  ex- 

1  Rainfall  and  Snow  of  the  United  States.    Prof.  M.  W.  Harrington,  Washington,  1894. 

18 


274  MEDICAL  CLIMATOLOGY. 

pected  than  iu  the  country  more  than  fifteen  or  twenty  miles  away 
on  either  side.  Two  of  these  are  especially  noticeable — one  in  the 
mountain-ranges  north  of  Santa  Fe  and  Las  Vegas  and  west  of 
Springer,  where  the  rainfall  surpasses  by  5  or  10  inches  a  year  that 
in  the  area  immediately  around  it ;  and  the  other  around  Fort  Stan- 
ton, in  the  mountains  to  the  east  of  the  Rio  Grande.  The  rainy 
season,  as  in  Colorado,  is  in  July  and  August.  In  the  vicinity  of 
El  Paso  40  per  cent,  of  the  rainfall  of  the  year  descends  in  these 
two  months. 

Captain  W.  A.  Glassford,  of  the  Signal  Corps,  U.  S.  A.,  describes 
the  process  of  annual  precipitation  as  follows  •} 

^^In  New  Mexico  the  winter-precipitation  does  not  begin  until 
the  earlier  days  of  January.  By  April  the  winter-rains  are  defi- 
nitely ended,  but  in  the  eastern  or  Atlantic  Divide  section  (the  Pecos 
Valley  region)  an  area  of  considerable  precipitation  remains.  This 
follows  the  high  summits  of  the  Sangre  de  Cristo  range  until  it 
sinks  into  the  tableland  of  4000  feet,  thence  it  tends  southeasterly 
across  the  Pecos  head- waters  region  as  far  as  Gal  Unas  Springs,  where 
it  sharply  curves  to  the  north  and  extends  over  the  Raton  range. 
The  winter-rains,  according  to  the  nomenclature  of  the  meteorologist, 
are  marked  by  curves  of  from  1  to  7  inches  of  precipitation,  running 
nearly  parallel.  These  curves  are  outside  the  mountain-lines  and 
indicate  the  diffuse  and  diverting  influence  of  topography  on  the 
aqueous  currents  borne  to  Xew  Mexico  from  the  South  Pacific  Oceau 
across  Arizona. 

^' The  summer-rains  are  otherwise  influenced,  and  the  highest  pre- 
cipitations appear  upon  the  levels  west  of  the  Canadian  River,  and 
upon  the  caiion-course  of  the  Pecos,  which  includes  Las  Vegas  and 
Fort  Union  ;  at  this  point  the  fall  reaches  17  inches.  The  lowest 
summer-precipitation  is  found  in  sections  most  favorably  influenced 
by  the  winter-rains.      The  minimum  is  foimd  in  the  southwest. 

^'Step  by  step  the  humid  winds  are  drawn  across  over  graduated 
plateaus  and  extrusive  summits,  and  at  each  higher  step  discharge  so 
much  of  their  moisture  as,  is  a  surplusage  over  the  saturation-amount 
of  atmosphere  of  a  given  tenuity  at  a  given  temperature. 
There  is  nothing  violent  in  these  systematic  draughts  of  the  humid 
air  from  the  sea  toward  the  continental  cyclones  or  vortexes ;  the 
air  is  chilled  by  the  seasonal  causes  which  make  the  winter  climate. 

1  New  Mexico.    Ofticial  Pablicatioa  of  the  Bureau  of  Immigrdtion,  Max  Frost,  Secretary. 
Santa  Fe,  1894. 


ROCKY  MOUNTAIN  REGION.  275 

The  earth-surfaces  soon  become  largely  covered  with  snow,  and  their 
radiating  influence  is  thus  mechanically  obliterated  ;  the  air  lies  in 
practically  even  strata  of  uniform  temperature.  The  humid  wind  is 
drawn  along  these  ruling  conditions;  on  every  plateau  it  discharges 
down  to  the  point  of  saturation  ;  tho  diminution  in  actual  amount 
of  moisture  is  constant  and  large;  by  the  time  it  overlies  the  Rio 
Grande  trough  its  last  available  moisture  has  been  condensed  by  the 
heights  of  the  Continental  Divide,  and  shifts  down  to  leeward.  Such 
precipitation  as  is  induced  appears  as  snow,  which  forms  a  storage 
whose  supply  is  constantly  utilized  until  July.  With  the  vanishing 
screen  of  snow  the  conditions  proportionately  alter.  The  surface  of 
the  elevation,  with  its  soil  and  rock-masses,  ceases  to  reflect  the  in- 
cident heat-rays  of  the  sun,  but  absorbs  much  of  it ;  at  the  same 
time  it  radiates  the  heat  which  it  receives,  currents  are  formed  in 
the  surrounding  air,  and  the  mountain  becomes  a  focus  of  activity, 
about  which  are  currents  rushing  rapidly  skyward  and  a  lateral 
draft  to  supply  the  place  of  the  air  withdrawn  by  its  action  of  con- 
vection; its  excess  of  moisture  and  consequent  precipitation  therefore 
reach  the  maximum." 

The  greatly  decreased  altitude  and  more  southern  latitude  of  the 
lower  Rio  Grande  Valley  together  combine  to  provide  a  place  of 
residence  for  winter  for  those  who  seek  refuge  from  the  higher  and 
cooler  regions  above. 

In  referring  to  this  country  El  Paso  will  be  considered  as  be- 
longing, climatically,  to  New  Mexico. 

The  climate  of  the  elevated  towns  in  the  northern  part  of  the 
State  is  similar  to  that  of  Colorado.  There  is  a  great  resemblance, 
for  instance,  between  the  temperature  of  Santa  Fe  (70 JO  feet)  and 
Las  Vegas  (6500  feet)  and  that  of  Denver.  Silver  City  (5800  feet), 
in  the  southwest,  has  a  milder  climate  and  is  sheltered  from  severe 
winds.  Albuquerque  (5000  feet)  is  a  larger  town,  with  better 
accommodations,  but  more  exposed  to  the  wind.  Las  Cruces, 
Eddy,  and  El  Paso  (3700  feet)  offer  each  about  the  same  elevation, 
but  varying  grades  of  accommodations. 

The  general  mean  of  relative  humidity  during  the  year  is  about 
40  per  cent.,  which,  with  the  average  annual  temperature  of  about 
60°,  shows  for  the  year  2.30  grains  of  moisture  to  a  cubic  foot  of 
air,  or  about  the  same  dryness  as  Colorado — the  higher  temperature 
increasing  slightly  the  amount  of  absolute  humidity. 

The  fine  climate  of  New  Mexico  is  its  greatest  asset.     Unfortu- 


276  MEDICAL  CLIMATOLOGY. 

nately,  there  are  no  cities  of  importance,  and  the  comforts  of  civili- 
zation are  not  easy  to  find,  except  in  two  or  three  towns. 

''  Sun,  silence,  and  adobe  !"  is  the  graphic  summary  of  the  country 
made  by  Ciiarles  F.  Linumis  in  his  delightful  book,  The  Land  of 
PoGO  Tiempo.  The  adobe  Indian  pueblos  where  he  lived  would,  of 
course,  be  avoided  by  invalids  ;  but  even  Santa  Fe  will  be  found  some- 
what unsanitary,  although  quaint  and  interesting.  320  cloudless 
days  a  year  can  be  claimed  for  any  portion  of  this  great  domain,  but 
gravel-soil,  soft  water,  and  good  supplies  are  more  difficult  to 
rely  on. 

The  cliiuate  is  superb.  It  is  in  the  details  of  living  that  the 
visitor  is  most  liable  to  meet  with  disappointment.  Among  other 
testimony  relating  to  the  climate  that  of  Ex-Surgeon-General  W. 
A.  Hammond  is  valuable.  He  says:  ''New  Mexico  is  by  far  the 
most  favorable  residence  in  the  United  States  for  those  predisposed 
to  or  afflicted  with  phthisis  .  .  .  In  a  service  of  three  years  in 
New  Mexico,  during  which  period  I  served  at  eight  different  sta- 
tions, ranging  from  the  extreme  northern  to  the  extreme  southern 
part  of  the  territory,  I  saw  but  three  cases  of  phthisis,  and  those 
were  in  persons  recently  arrived  from  the  United  States.  Inflam- 
mation of  the  lungs  is  also  very  infrequent,  as  are  likewise  pleurisy 
and  bronchitis." 

Dr.  W.  M.  Yandell,  of  El  Paso,  asserts  that  if  a  mild  climate 
during  the  cold  season  is  desired.  New  Mexico  and  Arizona,  south 
of  the  thirty-fifth  parallel  of  latitude,  furnish  by  far  the  best 
winter  climate  in  the  United  States  for  consumptives. 

The  summers,  however,  in  the  southern  portion  are  exceedingly 
hot.  The  heat  begins  to  gain  in  strength  after  the  middle  of  March 
and  increases  up  to  September  and  October.  In  spite  of  the  low 
humidity  the  impaired  vital  forces  of  an  invalid  are  apt  to  be  weak- 
ened by  the  prolonged  high  temperature. 

On  the  mountains  a  comfortable  summer  climate  can  be  found, 
the  nights  in  particular  being  usually  cool.  Santa  Fe  has  very 
few  hot  days,  and  for  those  who  enjoy  camping-out  the  fine,  wooded 
country  of  the  Upper  Pecos — where  there  is  said  to  be  plenty  of 
game  and  where  the  streams  ''  abound"  in  trout — or  the  top  of  the 
Black  Range,  will  bring  the  visitor  into  a  delightful  summer  climate 
and  an  interesting  country. 

The  annual  wind-movement  in  the  elevated  northern  portions  of 
the  State  is  about  the  same  as  that  of  Colorado,  but  the  wind-move 


ROCKY  MOUNTAIN  REGION.  277 

meut  of  the  lower  and  more  southerly  portions  is  less,  as  is  shown 
by  the  tables.  A  disagreeable  feature  of  all  open,  treeless  plains  is 
the  occasional  dust-storm,  which  is  the  more  objectionable  when  the 
soil  is  adobe  in  character,  producing  a  very  fine  dust,  which  pene- 
trates every  crack  and  cranny,  no  matter  how  obscure.  Furious 
dust-storms  are  not  frequent  and  are  rarely  of  longer  duration  than 
a  few  hours. 

Springer  (elevation,  5700  feet;  population,  900)  is  situated  on 
the  main  line  of  the  Atchison,  Topeka  and  Santa  Fe  Railroad, 
about  fifty  miles  south  of  the  Raton  Range,  Springer  is  the  centre 
of  a  rich  and  fertile  country.  Forty  miles  to  the  west  are  the 
Rocky  Mountains,  as  represented  by  the  Taos  and  Sangre  de  Cristo 
ranges,  whose  average  elevation  is  10,000  feet  and  whose  peaks 
reach  an  altitude  of  13,000  feet.  The  soil  is  adobe,  the  clay  having 
a  depth  of  several  feet.  The  country  is  under  an  immense  irriga- 
tion-system, and  large  lakes  are  projected  in  the  foot-hills,  thirty 
or  forty  miles  northwest  of  the  town. 

Large  ranches  have  been  the  rule  previously  throughout  this 
region,  which  has  been  devoted  mainly  to  stock-growing  and  the 
cultivation  of  alfalfa.  As  the  irrigation-ditches  are  extended 
smaller  fruit-ranches  will  become  more  numerous.  The  climate 
is  fine,  with  apparently  an  uneven  rainfall.  The  Pacific  passage- 
winds  which  reach  these  ranges  are  relieved  of  their  last  moisture, 
and  the  precipitation  even  on  the  eastern  slope  is  considerable.  The 
snowfall  is  said  to  be  from  15  to  20  feet  on  the  level  on  the  moun- 
tain-summits, or  in  water-measurement  about  50  inches,  an  estimate 
that  is  probably  too  liberal. 

In  the  valleys  the  mercury  rarely  falls  as  low  as  zero,  and  the 
summer-heat  is  not  excessive.  Good  well-water  is  said  to  be  obtain- 
able, and  there  are  some  artesian  wells. 

There  are  no  complete  weather-records,  but  from  the  voluntary 
observers'  report  the  following  facts  are  obtained  : 

winter.         Spring.       Summer.      Autumn.       Year, 
Temperature,  1892,     35°  53°  68°  51°  50° 

Maximum,     99°  Minimum,  —5° 

Winter- estimate  is  made  up  of  two  Decembers  and  January,  as  the  month 
of  February  is  missing.  Spring-estimate  is  for  April  and  May  only.  March 
record  missing. 


278 


MEDICAL  CLIMATOLOGY. 


Inches.        Inches.         Inches.         Inches.         Inches. 
Rainfall,  1891,  3.04  3.07  10.53  5  28  21.92 

1892,  0.63  5.23  5.31  2.78  13.93 

The  precipitation  in  the  summer  of  1891  was  unusually  heavy. 

The  record  for  1893  is  incomplete.  The  mean  monthly  tempera- 
ture for  spring  was  50°  and  for  summer  71°.  The  total  rainfall 
for  spring  was  11.93  inches  and  for  summer  7.02  iuches. 

Las  Vegas  (elevation,  6500  feet;  population,  6000).  Las  Vegas, 
like  most  of  the  Mexican  towns  in  New  Mexico,  has  a  mixed  popu- 
lation, consisting  perhaps  half  of  Americans  and  half  of  Mexicans 
and  Indians.     The  la.st  two  live  in  low  adobe-dwellings. 

The  town  is  hot  and  dusty  in  summer,  while  in  winter  the  tem- 
perature occasionally  goes  to  zero  or  below.  During  the  day  and 
in  the  sunshine,  however,  it  will  be  found  warm  and  comfortable. 
The  town  lies  somewhat  exposed  to  north  winds. 

Of  the  rainfall  of  20  inches  a  year  about  half  falls  during  July 
and  August,  with  some  rain  during  September  and  April.  During 
the  first  four  months  of  the  year  high  winds  blow,  as  is  the  case  in 
most  towns  of  the  plains.  Las  Vegas  is  a  healthy  place,  with  the 
generally  fine  climate  and  bountiful  sunshine  of  New  Mexico. 

Las  Vegas  Hot  Springs  (6700  feet)  are  seven  miles  from  the 
town,  lying  in  a  position  that  is  well  sheltered  from  the  winds. 
Here  one  can  get  mud-baths  of  great  efficacy  in  rheumatism  and 
kindred  troubles.  There  are  both  hot  and  cold  springs.  A  general 
analysis  of  the  hot  springs  made  by  Dr.  Walter  S.  Haines  shows 
the  temperature  to  be  140°  F. 


Calcium  carbonate 

Grains  per  gallon. 
.        0.89 

Magnesium  carbonate 

.       0.15 

Sodium  carbonate 

.       8.38 

Potassium  carbonate  . 

.       0.28 

Sodium  sulphate 

.       3.45 

Sodium  chloride 

.     14.68 

Silica 

.       3.50 

Alumina     .... 

.      0.10 

Volatile  and  organic  matter 

.       0.32 

Lithium  carbonate 

.     trace 

Sodium  bromide 

.     trace 

Total  solids 

.     31.65 

"The   Montezuma."    built    by  the   Santa    Fe    Railroad,  is  one 
of  the  largest  and  best  hotels  in  the  mountains,  but  is  at  present 


ROCKY  MOUNTAIN  REGION.  279 

closed.  It  is  about  7000  feet  above  the  sea.  There  are  picturesque 
canons  to  explore  and  fine  mountain-scenery. 

Santa  Fe  (elevation,  7000  feet ;  population,  7000).  This  still 
retains  the  appearance  of  a  Mexican  town,  the  outgrowth  of  an  old 
Indian  pueblo.  The  plaza,  the  winding  streets,  and  the  adobe- 
houses  are  interesting  features  to  visitors. 

The  town  lies  on  a  treeless  plain,  at  the  base  of  one  of  the  spurs 
of  the  Rocky  Mountains.  The  general  trend  of  the  valley  or  plain 
is  west  southwest,  the  mountains  affording  protection  to  the  north 
and  east.  Within  thirty  miles  are  peaks  of  12,000  and  13,000  feet 
elevation.  The  low  hills  are  covered  with  a  growth  of  pinon-trees. 
The  town  has  of  late  years  improved  its  water-supply,  but  much  is 
yet  to  be  desired  in  the  matter  of  drainage,  and  there  are  few  shade- 
trees.      The  soil  is  light  and  sandy. 

The  climate  is  not  very  different  from  that  of  Denver.  It  is 
somewhat  cooler  during  the  summer,  not  quite  so  cold  in  winter, 
and  a  little  less  windy  throughout  the  year. 

The  windiuess  of  Santa  Fe  has  beeu  so  frequently  alluded  to  that 
it  may  be  well  to  call  attention  to  the  fact  that  the  hourly  velocity 
of  the  wind  during  the  year  is  much  less  than  in  New  York,  Bos- 
ton, or  Chicago.  The  Government  record  for  ten  years  shows  for 
Santa  Fe  an  annual  mean  of  6.4  miles;  for  New  York  City,  9.4 
miles;  for  Boston,  10.9  miles  ;  and  for  Chicago,  9.6  miles  per  hour. 

The  weather-record  for  Santa  Fe  is  said  to  show  for  the  past 
twenty  years  but  eight  days  when  the  thermometer  registered  over 
90°,  and  but  fifteen  times  during  the  same  period  when  it  went 
below  zero.  Average  number  of  days  in  a  year  below  32°,  134; 
cloudy  days,  48;  stormy  days,  72  (means  for  six  years).  Average 
temperature  for  January,  28°;  for  July,  70°;  for  the  year,  49° 
(means  for  seventeen  years). 

The  maximum  temperature  in  Santa  Fe  was,  during  the  summer 
of  1891,  87°;  1892,90°  (one  day);  1893,89°  (one  day);  1894, 
84°;  1895,  87°. 

There  is  a  good  hotel  in  Santa  Fe,  and  an  excellent  sanatorium, 
managed  by  Sisters  of  Charity. 

Upper  Pecos  Valley  and  Timber  Reservation,  covering  702 
square  miles.  The  region  is  rugged  and  mountainous,  with  numerous 
small  streams,  which,  flowing  south,  form  the  Pecos  River. 

In  the  beautiful  upland  valley,  for  twenty  miles  north  of  the  Glo- 
rieta  Mountains,  are  scattered  stock-ranges  and  small  farms.     It  is 


280  MEDICAL  CLIMATOLOGY. 

an  attractive,  park-like  district,  well-timbered  and  surrounded  by 
mountains.      The  altitude  ranges  from  6000  to  8000  feet. 

Not  only  is  the  location  picturesque,  but  there  are  also  good  soil, 
water,  and  climate.  Much  of  the  country  is  wild,  and  game  is  found, 
includino-  bear  and  deer,  while  the  streams  are  well  filled  with  trout. 
It  lias  not  been  in  any  way  developed  as  a  health-resort,  but  its 
natural  advantages  are  too  great  to  allow  it  to  remain  long  unknown. 

Throuo^h  the  lower  end  of  the  vallev  the  main  line  of  the  Santa  Fe 
Railroad  passes,  between  San  Miguel  and  Glorieta. 

The  only  way  of  learning  to  know  the  attractions  of  the  country 
at  present  is  by  camping-out. 

Albuquerque  (elevation,  5000  feet ;  population,  8000).  This 
town  is  situated  in  a  wide  valley,  watered  by  the  Rio  Grande,  and 
is  on  the  Atlantic  and  Pacific  division  of  the  Santa  Fe  Railroad 
system.  It  is  quite  well  known  as  a  health-resort  station.  The 
spirit  of  the  town  is  progressive,  and  it  has  street-cars,  waterworks, 
and  electric  lights,  gas,  and  sewers.  There  are  churches  of  all 
denominations,  and  a  hotel.  Albuquerque  has  a  large  social  club- 
building,  but  there  are  few  diversions  for  visitors.  In  selecting  a 
place  of  residence  it  is  important  for  an  invalid  to  live  on  the  mesa 
or  table-land,  as  far  from  the  influence  of  the  river  as  possible,  for 
intermittent  and  malarial  fevers  are  not  unknown  on  the  river  bot- 
tom-laud in  the  '^old  town". 

There  is  no  detailed  weather-record.  The  temperature  for  1892 
by  seasons  was  as  follows  :  winter,  41°;  spring  (March  missing), 
60°;  summer  (June  missing),  77°;  autumn,  58°;  maximum,  97°; 
minimum,  15°.  Mean  for  January,  41°;  for  July,  78°.  For  the 
year  1893  :  winter,  38°;  spring,  54°;  summer,  72°;  autumn,  53°; 
annual  mean,  55°;  maximum,  98°;  minimum,  11°.  Mean  for  Jan- 
uary, 37°;  for  July,  77°. 

The  mean  annual  rainfall  is  about  8  inches,  of  which  over  4  inches 
may  be  expected  during  the  summer-months.^  No  report  of  the 
wind-movement  is  obtainable,  but  the  situation  of  the  town  is  open 
and  exposed. 

Deming-    (elevation,  4300  feet  r  population,  2000).      This  town 

1  Rainfall  and  Snow  of  the  United  States.  Prof.  M.  H.  Harrington,  1S91.  Mean  aunnal  rain- 
fall of  Albuquerque  for  ten  years,  7.7  inches.  Buck's  Reference  Handbook  of  the  Medical 
Sciences  gives  the  mean  rainfall  for  17  years  as  8.12  inches.  Precipitation  for  June,  July, 
and  August,  4.35  inches. 

-  The  engineers  of  the  Santa  Fe  Railroad  have  estimated  the  elevation  of  Deming  at  3600 
feet.  Barometric  determinations  of  the  Signal  Service  give  the  approximate  elevation  at  4303 
feet. 


ROCKY  MOUNTAIN  REGION.  281 

is  situated  ou  a  })lain  about  fifty  miles  square,  surrounded  by  luoun- 
taius.  It  is  on  the  line  of  the  Atchison,  Topeka  and  Santa  F6  and 
tlie  Southern  Pacific  Railways. 

The  climate  is  mild,  the  temperature  never  going  below  32° 
during  the  day  in  winter.  The  mean  of  the  rainfall-record  for  nine 
years  is  8.8  inches,  the  precipitation  being  principally  in  July,  Au- 
gust, and  September.     The  winds  begin  in  February. 

The  town-water  is  brought  from  the  Black  Range — a  spur  of  the 
Rockies.  There  are  also  a  number  of  windmills  for  the  purpose  of 
raising  water. 

The  following  is  the  mean  seasonal  temperature  for  two  years  : 
winter,  44°;  spring,  63°;  summer,  87°;  autumn,  64°.  Mean  for 
the  month  of  January,  40°. 

Silver  City  (elevation,  5800  feet;  population,  3000;  latitude, 
32°  46'  north)  is  situated  on  an  elevated  plateau  in  the  Chihuahua 
Valley,  south  of  the  Pinos  Altos  hills.  It  lies  at  the  end  of  a 
branch-line  of  the  Santa  Fe  Railroad,  running  up  forty-eight 
miles  from  Deming.  Silver  City  is  about  ten  and  one-half  hours 
by  rail  from  El  Paso. 

The  climate  is  considered  very  salubrious,  being  mild  during  the 
winter  and  spring  and  not  subject  to  sudden  changes,  while  during 
the  heat  of  summer  it  is  possible  to  go  a  little  higher  into  the  cooler 
regions  of  the  pines. 

In  winter  the  frosts  are  said  to  be  less  severe  than  in  the  valleys 
of  lower  altitude  along  the  Rio  Grande. 

The  record  of  temperature  for  ten  years^  shows  the  mean  for 
January  to  be  37°;  for  July,  72°;  for  the  year,  54°.  By  seasons 
it  is  as  follows  :  winter,  37°;  spring,  53°;  summer,  72°;  autumn, 
55°.  The  highest  record  (in  June,  1871)  is  100°  and  the  lowest  1°. 
In  ten  years  there  were  only  22  days  above  90°  and  6  days  below 
10°.  The  average  annual  precipitation — based  ou  a  record  for 
twenty  years — is  14.58  inches,  of  which  8.11  inches  usually  fall 
in  July,  August,  and  September. 

The  average  number  of  cloudy  days  during  the  year  is  37.  Buck's 
Reference  Handbook  of  the  Medical  Sciences  states  that  the  relative 
humidity  showed  an  average  of  50  per  cent,  for  one  year.  The 
average  during  the  winter  was  49  per  cent.     The  same  authority 

1  Quoted  by  A.  F.  McKay,  in  American  Climates  and  Resorts,  November,  1894. 


282  MEDICAL  CLIMATOLOGY. 

refers  to  Silver  City  as  "enjoying  the  exceptional  advantage  of 
shelter  from  the  wind."  Actual  wind -records  were  not  obtainable, 
but  the  movement  is  small. 

Silver  City  has  been  called  an  American  town  with  a  Mexican 
quarter,  to  distinguish  it  from  many  of  the  towns  in  New  Mexico 
where  the  old  Mexican  influence  still  predominates.  The  build- 
ings consist  largely  of  brick,  which  is  manufactured  there.  An 
ample  supply  of  town-water  is  obtained  from  welh  flowing  into  the 
reserv^oir  above  the  town.  An  analysis  made  by  Professor  W.  E. 
Waring  shows  an  excellent  quality  of  hard  water.  His  report  gave 
the  number  of  grains  of  "total  hardness"  per  gallon  as  11.72, 
which  would  be  equal  to  about  20  parts  of  "total  hardness"  per 
100,000  parts.  Softer  water  can  be  obtained,  it  is  said,  from  some 
of  the  artesian  v/ells. 

The  soil  is  of  a  sandy  nature.  The  general  rock-formation  of 
the  vicinity  is  principally  slate  and  limestone. 

Besides  the  usual  public  buildings  there  are  four  hotels,  one  of 
them  a  large  three-story  brick  building,  and  a  Sisters'  Hospital. 
There  is  very  little  irrigation  around  Silver  City  ;  fresh  vegetables 
and  grapes  are  supplied  from  neighboring  ranches. 

This  portion  of  New  Mexico  offers  every  advantage  for  outdoor 
life.  The  pine-forests  on  the  mountains  are  available  tor  camping, 
and  small  game  is  said  to  be  abundant.  The  roads  are  good.  The 
heat  is  more  moderate  during  spring  and  summer  than  in  the  lower 
river-valleys,  and  there  is  more  freedom  from  dust  and  insects. 

Fort  Bayard  is  a  postofiice  and  United  States  Army  post,  lying 
at  a  lower  altitude  than  Silver  City  and  distant  nine  miles  northeast. 
The  extent  of  its  accommodations  is  not  known  to  the  writer.  Its 
population  was  over  500  by  the  census  of  1890.  The  height  of 
Fort  Bayard  is  given  in  Toner's  Dictionary  of  Elevations  as  445Q 
feet  above  the  sea.  In  1893  the  air-temperature  by  seasons  was  as 
follows  :  winter,  41°;  spring,  52°;  summer,  72°;  autumn,  55°. 
Annual  mean,  56°;  maximum,  99°;  minimum,  13°.  Mean  monthly 
temperature  for  January,  41°;  for  July,  74°.  The  rainfall  during 
the  year  1893  was  slight  in  all  the  months  except  July,  August, 
and  September,  when  12|  inches  fell. 

The  Valley  of  Mesilla  (see  Las  Cruces)  is  about  seventy  miles 
long  and  from  one  to  six  miles  wide.  Its  elevation  varies  from  4000 
feet  at  the  Rio  Grande,  to  7000  feet  among  the  foot-hills.     The 


ROCKY  MOUNTAIN  REGION.  283 

climate  is  mild,  ranking  high  for  dry  air  and  continuance  of  sun- 
shine.    Snow  is  rarely  seen. 

The  valley  produces  a  fine  variety  of  grape  containing  a  large 
amount  of  sugar.  Because  of  the  fertile  soil  in  the  lower  portion 
this  district  is  one  of  the  garden-spots  of  New  Mexico.  Mesilla  was 
formerly  noted  for  being  one  of  the  least  windy  of  the  Government 
weather-stations,  but  no  official  observations  have  been  taken  for 
several  years. 

The  wind-movement  for  Mesilla,  given  in  Dr.  Denison's  charts,^ 
shows  for  the  year  2.3  miles  per  hour  and  for  winter  2,1  miles 
per  hour. 

The  average  temperature  by  seasons  is  :  winter,  42°;  spring,  61°; 
summer,  78°;  autumn,  60°;  year,  63°. 

Buck's  Reference  Handbook  of  the  Medical  Sciences  gives  the  mean 
relative  humidity  for  one  year  as  41  per  cent.,  and  for  three  months 
of  winter  as  43  per  cent. 

Las  Cruces  (elevation,  3800  feet ;  population,  3000).  This  is 
one  of  the  Mexican  towns  above  El  Paso,  distant  forty-three  miles 
— a  little  over  an  hour's  ride  by  rail  on  the  Atchison,  Topeka  and 
Santa  Fe  Railroad.  The  Mesilla  Valley  in  which  it  lies  is  wide, 
and  when  irrigated  the  soil  is  fertile.  Fine  grapes  are  grown,  and 
large  fields  of  alfalfa.  The  principal  supply  of  water  for  irrigation 
is  drawn  from  the  Rio  Grande ;  there  are  also  a  number  of  arte- 
sian wells,  which  furnish  water  for  domestic  use.  The  water,  while 
alkaline,  is  said  to  be  wholesome,  and  is  best  when  obtained  near 
the  centre  of  the  valley. 

The  houses  in  Las  Cruces  are  usually  one  story  in  height,  and 
are  built  of  adobe.  There  are  two  small  hotels.  Good  board  in 
the  town  can  be  had  at  Mrs.  Barker's,  and  in  Doiia  Ana,  one  mile 
from  the  Las  Cruces  railroad  station,  at  "The  Alameda." 

The  mean  temperature  for  January  is  39°.  Extreme  yearly 
range  from  — 2°  to  106°.  The  average  rainfall  for  twenty  years 
has  been  at  the  rate  of  7  inches  a  year.  The  number  of  cloudy 
days  from  August,  1892,  to  July,  1893,  inclusive,  was  20.  The 
average  wind-movement  is  said  by  one  writer  to  be  about  5^  miles 
per  hour,  which  is  probably  an  overestimate. 

Winter  visitors  can  remain  until  April  without  suffering  from 
the  heat. 

>  Climates  of  the  United  States  in  Colors.    Charles  Denison. 


284  MEDICAL  CLIMATOLOGY. 

The  Van  Patten  Mountain  Camp  is  situated  fifteen  railes  east 
of  Las  Cruces,  at  an  elevation  of  6000  feet,  in  a  sheltered  notch  of 
the  Organ  Mountains.  It  is  protected  by  rocky  walls  from  all 
winds,  and  has  an  abundance  of  pure  mountain- water. ^  Small 
game  can  be  found  in  the  vicinity.  The  greatest  height  of  the 
Organ  Mountains  is  about  8000  feet. 

Twenty-five  miles  east  of  Las  Cruces,  on  the  eastern  slope  of  the 
Organ  Mountains,  Dr.  Petin  has  selected  a  site  for  a  sanatorium  as 
affording  the  greatest  advantages. 

Its  claims  to  favorable  consideration  are  "  moderate  altitude  of 
4800  feet,  good  mineral- water,  no  malaria  or  dust,  porous  soil,  tem- 
perature quite  eveu,  with  an  annual  average  of  62°  F.  Scarcely 
any  snowfall.  Rainfall  about  4(?)  inches  a  year.  But  little  wind. 
There  is  an  abundance  of  game  of  all  kiuds  and  good  fishing. 
Beautiful  shade-trees  grow  at  the  foot  of  the  mountains.  There 
any  patient  can  sleep  out  of  doors  eight  months  of  the  year  without 
fear  of  catching  cold." 

As  yet  there  are  no  accommodations  for  iuvalids.  It  is  necessary 
to  camp  out  and  rough  it. 

Pecos  Valley.  Principal  town  Eddy  (elevation,  3200  feet ; 
population,  2000).  An  extensive  scheme  of  irrigation  is  transform- 
ing this  valley  in  Southern  New  Mexico  from  an  alkali-desert  into 
a  fruitful  region.  There  are  two  or  three  Xax^o.  canals  now  in 
operation,  the  water  being  taken  from  the  Pecos  River,  which  not 
only  carries  a  large  amount  of  rainfall  and  snowfall  from  the  Rockies, 
but  is  fed  along  its  course  by  numerous  living  springs,  flowing  from 
fissures  in  the  limestone  which  underlies  the  couutry.  This  river- 
water  has  been  analyzed  by  Professor  Precht,  as  follows: 

Grains  per  gallon. 

Calcium  and  sodium  chloride G9.23 

Sodium   sulphate  (Glauber's  salt)  and  magnesium 

sulphate  (Epsom  salt) 34.62 

Calcium  carbonate 39.00 

Calcium  sulphate 30.00 


Total  solids        ....     172.85 

The  amount  of  alkali  present  is  indicated  in  another  way  by  the 
deposit  of  over  two  tons  of  salts  yearly,  per  acre,  on  the  irrigated 
land,  which  is  claimed  to  be  of  benefit  to  the  soil  for  fertilizing- 

1  A.  F.  McKay,  in  American  Climates  and  Resorts. 


ROCKY  MOUNTAIN  REGION.  285 

purposes.  Water  can  also  be  obtained  by  means  of  artesian  wells. 
Eddy  secures  its  town-supply  in  this  way. 

There  is  no  timber  in  the  valley  except  mesquite/  but  plenty  of 
timber  is  found  fifty  to  one  hundred  miles  west.  The  air  is  pure  and 
dry.     There  are  from  320  to  340  days  of  sunshine  during  the  year. 

The  winters  are  mild  and  the  summers  hot,  the  nights  being 
usually  cool.  Tlie  extreme  range  of  temperature  is  reported  to  be 
from  102°  above  zero  to  7  °  below,  but  the  mercury  in  winter 
seldom  drops  so  low.     The  annual  average  is  63°. 

The  rainfall  is  about  8  inches  yearly. 

The  wind-movement  is  not  obtainable.  The  most  objectionable 
feature  is  said  to  be  the  spring-winds,  which  are  not  dangerously 
heavy,  but  tiresomely  persistent  and  charged  with  light  sand. 

Eddy  is  a  small  town  recently  built.  Fairly  good  accommoda- 
tions can  be  secured  at  ''Hotel  Hagerman,"  or  furnished  ranch- 
houses  of  moderate  size  can  be  hired. 

The  Eddy  Argus  for  April,  1894,  contained  a  review  of  the 
weather  for  the  preceding  five  months,  which  showed  the  following  : 

Mean  temperature. 


6.30  A.M.  10  P.M. 

November,  1893 36°  48° 

December,  1898 
January,  1894 
February,    1894     . 


35  43 

31  32 


.     32  41 

2  P.M. 

March,         1894 40         71°  53 

Average  temperature  for  the  month  of  March      .  .  59 

Cloudy  days,  November  1,  1893,  to  April  1,  1894.  .  43 

Windy  days,  November  1,  1893,  to  April  1,  1894  .  .  52 

During  the  winter  of  1894-'95  the  monthly  means  at  Eddy  were 
as  follows  (based  on  the  reports  of  G.  \Y.  Lane,  observer)  : 


Temperature 

. 

Rainfall 

Mean. 

Mean  max.    Mean  min. 

inch. 

Cloudy  days 

November,  1894, 

54° 

70° 

37° 

0.00 

0 

December,     " 

45 

58 

32 

0.02 

1 

January,      1895, 

42 

57 

27 

0.65 

2 

February,       " 

37 

50 

23 

0.19 

9 

March,            " 

55 

72 

38 

0.00 

1 

April, 

64 

80 

47 

0.10 

1 

1  The  mesquite  is  a  sort  of  shrub  sometimes  growing  to  a  height  of  thirty  feet  or  more,  but 
usually  scrubby,  forming  dense  clumps  of  busby  thicket  or  chaparral. 


286  MEDICAL  CLIMATOLOGY. 

Snowfall  in  February,  1895 2.10  inches. 

Extreme  minimum  temperature  in  January,    1895       .         .       5° 

_2 

22 

88 

93 

14  days. 


"  "  "  February, 

"  "  "  March, 

"        maximum  "  March, 

"  "  "  April, 

Cloudy  days  from  November  1st  to  May  1st 

Wind-velocity  not  given. 


The  temperature  of  Eddy  by  seasons  is  as  follows  (based  on  the 
records  for  the  year  1894,  except  for  March  and  April,  which  are 
the  means  of  1894  and  1895):  winter,  40°;  spring,  QQ°;  summer, 
79°;  autumn,  65°;  mean  for  the  year,  62°.  Extreme  maxima  for 
summer — June,  104°;  July,  103°;  August,  96°;  all  for  the  year 

1894.  Extreme  minima  for  winter  1894  and  1895 — December,  18°; 
January,  7°;  February,  11°.     During  the  cold  wave  of  February, 

1895,  the  extreme  minimum  temperature  was  2°  below  zero.  The 
mean  daily  range  of  temperature  during  the  winter  months  is  34°, 
and  the  greatest  daily  range  will  average  41°., 

During  the  summer  of  1894  the  temperature  at  Eddy  rose  above 
90°  73  times,  and  above  100°  8  times. 

Roswell.  The  railroad  has  been  completed  for  seventy-five  miles 
north  of  Eddy  to  Roswell,  which  is  situated  at  an  altitude  of  4000 
feet,  and  has  a  population  of  about  1000.  The  older  ranches  are 
at  this  end  of  the  valley. 

MiNEEAL  Springs. 

Like  all  mountainous  countries.  New  Mexico  has  a  great  num- 
ber of  mineral  springs — both  hot  and  cold — but  only  a  few  of  them 
have  been  analyzed  or  developed.  The  best  known  are  the  Las 
Vegas  Hot  Springs  (6700  feet),  where  the  Atchison,  Topeka  and 
Santa  Fe  Railroad  has  built  a  fine  hotel.  An  analysis  of  these 
waters  will  be  found  in  the  description  of  this  resort. 

The  Polsom  Hot  Springs  (6500  feet),  near  Alps,  in  Colfax 
County,  are  said  to  have  medicinal  properties,  but  of  what  nature 
is  not  stated.  The  Ojo  Caliente  Springs  (6290  feet)  are  on  the 
creek  of  the  same  name  and  twelve  miles  from  Caliente  station,  in 
the  southwestern  portion  of  Taos  County.  They  have  a  tempera- 
ture of  108°  to  114°  F.  The  Jemez  Hot  Springs  (6700  feet),  in 
San  Diego  Canon,  Benalillo  County,  are  in  two  groups,  two  miles 


E  0  CK Y  MO  UNTAIN  REGION.  287 

apart,  and  they  vary  from  70°  to  168°  in  temperatnre.  Some  of 
them  flow  from  caves  of  carbonate  of  Hme.  Their  ingredients  are 
principally  sulphate  and  carbonates  of  sodium,  calcium,  and  magne- 
sium. At  Cherryville,  near  the  Black  Range,  southwest  of  Socorro, 
are  some  hot  springs,  close  by  the  falls  of  the  Alamosa.  The  elevation 
is  6500  feet  and  the  temperature  130°.  They  can  be  reached  from 
Engle.  In  the  southwestern  part  of  Socorro  County,  on  the  west  of 
the  Gila  or  Diamond  Creek,  is  a  group  of  springs  (elevation,  5500 
feet;  temperature,  130°)  similar  to  the  Jemez  Springs.  They  can 
be  reached  by  wagon  from  Silvertou.  Twenty-four  miles  uorth  of 
Deming  and  three  miles  from  Hudson  are  several  springs,  situated 
at  an  elevation  of  5780  feet.  They  contain  soda,  lime,  and  mag- 
nesia, and  the  water  has  a  temperature  of  130°. 

Arizona. 

An  inquiry  into  the  climate  of  Arizona  discloses  the  fact  that  it  is 
climatically  distiuct  from  each  of  its  neighbors — New  Mexico  and 
California — and  has  natural  laws  of  its  own,  although  these  laws  are 
modified,  in  turn,  by  the  climatic  influences  of  both  these  Pacific  coast 
and  the  Rocky  Mountains. 

Captain  W.  A.  Glassford,  of  the  Signal  Corps,  U.  S.  A.,  pre- 
pared in  1890  an  exhaustive  ''Report  on  the  Climate  of  Arizona, 
with  particular  reference  to  the  Rainfall  and  Temperature,"  which 
is  of  the  greatest  value  to  all  students  of  the  subject  and  from  which 
the  author  has  drawn  freely.  Although  the  report  was  the  result 
of  an  investigation  undertaken  in  order  to  learn  the  possibilities  of 
irrigation  in  the  territory,  the  information  gained  is  also  of  value 
for  the  benefit  of  invalids  for  whom  the  curative  power  of  climate 
is  necessary. 

To  understand  the  geographical  position  of  Arizona  attention 
must  first  be  directed  to  the  presence  of  the  great  Continental 
Divide,  which  passes  through  the  western  portion  of  New  Mexico 
in  a  fairly  direct  course  north  and  south  along  the  one  hundred 
and  eighth  degree  of  longitude. 

West  of  this  line  the  waters  all  flow  toward  the  Pacific  ;  and 
this  vast  country,  which  decreases  steadily  in  height  in  a  series  of 
plateaus  to  the  southwest  corner,  is  influenced  by  the  winter  rainy 
season  of  the  California  coast. 

The  northern  half  of  the  territory  is  also  affected  by  another  great 


288  MEDICAL  CLIMATOLOGY. 

divide,  running  southeast  and  northwest  (from  the  point  where  lati- 
tude 34°  crosses  the  New  Mexican  boundary  to  the  San  Francisco 
Mountains,  north  of  Flagstaff).  This  ridge  separates  the  watersheds 
of  the  Gila  and  Colorado  Rivers,  and  may  be  roughly  described  as 
lying  along  latitude  35°. 

''The  axis  of  the  mountain-system  of  Arizona,"  says  Captain 
Glassford,  ''is  remarkably  well  defined  aud  appears  with  the  utmost 
distinctness,  not  only  in  the  general  trend  of  the  main  mass  of  eleva- 
tion, but  also  in  minor  ranges  and  notably  in  detached  spurs,  often 
widely  separated  from  the  plateau-system,  to  which,  on  the  score  of 
altitude,  they  may  claim  to  belong.  With  sufficient  accuracy  to 
satisfy  all  legitimate  demands  of  the  present  inquiry,  the  direction 
of  the  mountain-axis  may  be  placed  at  northwest  and  southeast." 
In  the  valley  of  the  Rio  Santa  Cruz,  in  Pima  County,  there  are 
fifteen  peaks  rising  to  an  altitude  of  more  than  3000  feet  from  a 
mesa  2000  feet  high.  In  the  Gila  valley  are  twelv^e  members  of  a 
butte-system  rising  from  1000  to  2000  feet  abov'e  benches  1000  to 
3000  feet  high.  The  tableland  of  3000  feet  is  crowded  with  sierras 
of  5000  feet  aud  upward,  and  on  the  high  plateau  of  5000  feet  are 
six  examples  of  mountain-masses  risiug  from  7000  to  9000  feet,  and 
culminating  (in  the  group  called  the  San  Francisco  Mountains)  in 
three  peaks — Humphrey,  Agassi/,  and  Humboldt — of  which  the 
first  two  have  an  elevation  of  nearly  13,000  feet  above  the  sea. 
In  no  case  dogs  the  mountain-system  diverge  from  the  characteristic 
axial  direction. 

"  It  must  be  remembered  that  the  Pacific  Ocean  is  the  reservoir  of 
Arizona,  and  an  important  result  of  this  uniformity  of  the  moun- 
tain-axis, carried  consistently  over  five  hundred  miles,  is  that  the 
prevailing  moisture-bearing  wind,  being  from  the  southwest,  comes 
at  right-angles  to  the  broadside  of  the  mountains,  and  thus  encoun- 
ters the  maximum  bluff-surface. 

"  In  other  words,  the  passage  of  the  rainy  winds  across  Arizona 
is  by  no  means  an  easy  gliding  over  an  inclined  plane,  but  the  labo- 
rious ascent  of  a  flight  of  steps. "^ 

For  meteorological  purposes  Arizona  is  divided  into  three  series 
of  elevations  : 

1.  The  Plaix.  This  embraces  about  one-third  of  the  territory 
which  lies  to  the  south  and  west  below  the  level  of  3000  feet,  and 

'  Captain  W.  A.  Glassford. 


ROCKY  MOUNTAIN  REGION.  289 

iucludes  most  of  the  desert-country  that  has  given  Arizona  its  unen- 
viable reputation  for  heat  and  discomfort.  On  this  low  plain  the 
rainfall  is  only  from  2  to  6  inches  during  the  year,  and,  including 
the  desert  on  the  California  side  of  the  Colorado  River,  the  records 
appro>fimate  the  absolute  minimum  of  rainfall  of  the  world. 

It  was,  however,  a  careless  estimate  of  the  early  emigrants  to 
consider  it  all  a  desert,  as  this  area — as  great  as  that  of  Italy  or  the 
six  New  England  States — has  a  rich  alluvial  soil  along  the  river- 
bottoms,  brought  down  from  the  hillsides  by  centuries  of  washing, 
which  is  found  to  be  capable  under  irrigation  of  growing  almost  any- 
thing. Oranges,  lemons,  almonds,  figs,  apples,  grapes,  etc.,  all 
thrive  and  even  mature  earlier  than  in  Southern  California.  The 
mountains  above  can  furnish  the  needed  supply  of  water  if  it 
is  properly  stored,  and  this  rich  land  promises  to  be  eventually 
one  of  the  most  productive  agricultural  sections  of  the  United 
States.  Its  intense  heat,  unfortunately,  forbids  its  consideration  as 
a  health-resort  except  during  the  winter  months,  when  its  cloud- 
less skies  and  moderate  temperature  afford  perfect  immunity  from 
the  cold  and  snow  which  characterize  that  season  in  northern 
regions. 

2.  The  Pro-plateau  is  a  bench  of  from  3000  to  5000  feet 
elevation,  which,  from  its  geographical  and  physical  relations  to 
the  high  plateau  covering  fully  half  the  territory,  has  been  distin- 
guished by  this  term.  "  It  closely  follows  the  axial  inflection  of 
the  mountain-system,  although  its  continuity  is  somewhat  inter- 
rupted by  more  or  less  detached  spurs  of  its  higher  neighbor. 
Across  the  central  portion  of  the  territory  it  preserves,  with  con- 
siderable uniformity,  a  mean  width  of  less  than  one  hundred  miles. 
Widening  at  the  caiion  of  the  Gila,  it  covers  the  whole  southeastern 
corner  of  the  territory.  .  .  .  The  pro-plateau  is  so  narrow  a 
strip  for  the  greater  part  of  its  length,  and  so  vestibular  in  its  rela- 
tion to  the  plateau,  that  in  the  absence  of  climatic  data  it  should  be 
provisionally  included  in  the  great  plateau-mass  which  overshadows 
it.  This  may  be  well  done  with  all  that  portion  lying  northwest  of 
the  Gila.  The  southeastern  expansion  of  the  pro-plateau,  embracing 
portions  of  the  counties  of  Graham,  Pinal,  and  Pima  and  the  whole 
of  Cochise,  is  so  marked  by  two  systems  of  extrusive  highlands,  each 
composed  of  a  considerable  number  of  extensive  masses  of  elevation 
reaching  in  every  case  the  altitude  of  the  plateau  and  in  some  cases 
1000  or  2000  feet  higher,  that  this  region  may  be  rationally  included 

19 


290  MEDICAL  CLIMATOLOGY. 

iu  the  discussion  of  the  rain-making  influence  exerted  by  the  extru- 
sive summits  of  the  plateau." 

This  countr}^  is  that  surrounding  Tombstone,  Huachuca,  Critten- 
den, and  Calabesas,  as  far  as  Nogales  on  the  JNIexican  line.  There 
are  settlements  of  from  3000  to  6000  feet  elevation,  in  or  near 
canons  and  valleys,  affording  picturesque  S3enery  and  claiming  a 
delightful  winter-climate.  The  accommodations  are,  however, 
crude  and  primilive.  The  principal  industries  are  mining  and  fruit- 
raising. 

3.  The  Plateau.  This  is  an  approximately  level  mesa  above 
the  5000-foot  line,  which  embraces  more  than  half  the  territory.  It 
enjoys  the  greater  portion  of  the  rainfall,  chiefly  because  of  its  two 
mountain-systems.  These  summits  exert  an  important  influence  on 
the  yearly  rainfall. 

The  annual  amount  of  rainfall  on  the  pro-plateau  approximates 
10  inches  and  that  on  the  plateau  from  10  to  20  inches,  the  greatest 
precipitation  falling  to  the  south  of  the  Great  Divide — the  San  Fran- 
cisco Mountains. 

The  curve  of  precipitation  of  20  inches  appears,  first,  southeast  of 
Tucson,  over  the  Santa  Rita  Mountains  ;  secondly,  over  the  Natanes 
mountain-group,  between  the  valleys  of  the  Upper  Gila  and  Salt 
Rivers ;  thirdly,  over  the  flanks  of  the  Mogollan  range  and  the  San 
Francisco  Mountains  ;  fourthly,  iu  a  narrow  region  over  the  head- 
waters of  the  Hassayampa,  the  Agna  Fria,  and  the  Rio  Verde,  near 
Prescott ;  another  region  si'iowing  20  inches  is  the  high  country  east 
of  Fort  Apache,  over  the  White  Mountains  and  the  head-waters  of 
the  Little  Colorado,  extending  to  the  edge  of  New  Mexico.  A  small 
curve  of  25  inches  appears  south  of  the  San  Francisco  Mountains. 
These  are  '' islands  of  greater  rainfall,"  where  the  rainfall  decreases 
from  the  centre  in  every  direction,  until  not  more  than  half  the 
amount  of  rain  may  be  expected  but  a  few  miles  away.  One  point 
to  be  borne  in  mind  is  that  the  actual  maximum  rainfall  is  not 
known,  as  the  stations  are  for  the  most  part  in  the  valleys,  where 
the  gauges  cannot  record  the  heavy  rains  which  are  seen  on  the  tops 
of  the  mountains.  The  record  of  the  station  on  the  summit  of  Pike's 
Peak  in  Colorado  may  be  mentioned  to  illustrate  the  increased  pre- 
cipitation compared  with  the  plains,  although  it  shows  an  unexpect- 
edly low  average,  being  barely  30  inches  per  annum. 

A  noticeable  feature  of  Arizona  meteorology  is  that  it  has  t%Y0 
plainly    marked    rainy    seasons.      The    winter-rains    begin    usually 


ROCKY  MOUNTAIN  REGION.  291 

some  time  iu  December,  and  terminate  in  February.  *'As  iu  the 
case  of  the  seasonal  rains  of  California,  so  iu  Arizona  the  variability 
of  the  winter-rains  iu  amount  and  frequency  is  iu  the  ratio  of  the 

intensity    and    recurrence  of    barometric  disturbances 

These  rains  are  caused  by  the  proximity  of  approach  of  great 
storms  in  low-pressure  areas  wliich  form  a  part  of  the  storm - 
system  of  the  country  at  large.  .  .  .  They  are  moderate  in 
force  and  are  interrupted  by  the  anti-cyclonic  types  of  high 
barometer  and  cloudless  skies  which  are  distinctive  of  the  Pacific 
coast  weather."^  Much  of  the  winter-precipitatiou  occurs  in  the 
form  of  snow,  which  quickly  melts  on  the  plains,  while  on  the 
mountain-tops  it  may  be  found  from  three  to  seven  feet  deep. 
This  acts  as  a  storage-reservoir  to  supply  the  streams  through  the 
dry  season  almost  to  the  beginning  of  the  summer-rains.  In  fact, 
it  is  a  practice  of  the  Indians  and  old  settlers  to  calculate  that  when 
the  last  snow  disappears  on  the  mountain-summits  the  summer-rains 
commence. 

These  come  on  during  July,  August,  and  September,  ''  being 
somewhat  sharply  defined  from  the  preceding  dry  season,  but 
shading  off  so  indeterminately  toward  the  beginning  of  the  winter- 
rains  that  it  becomes  quite  proper  to  say  that  while  Arizona  has 
two  rainy  seasons  it  has  but  one  dry  season."" 

The  rains  of  summer  are  local  in  character  and  due  to  mountain- 
influences.  They  are  of  almost  daily  occurrence  on  the  high  sum- 
mits, falling  invariably  in  the  afternoon.  Their  intensity  is  re- 
markable. "From  30  to  40  per  cent,  of  the  entire  precipitation 
occurs  in  heavy  showers,  where  the  rainfall  is  upward  of  0.75  inch 
during  a  day  of  precipitation,  and  frequently  more  than  an  inch 
falls  iu  a  heavy  shower.""  The  brief  and  violent  summer-storms 
are  felt  almost  entirely  on  the  elevated  mesa  called  the  plateau. 
Captain  Glassford  is  authority  for  the  curious  statement  that  in 
Arizona  in  summer,  owing  to  local  causes,  ''the  greatest  pluvial 
effort  is  registered  on  the  leeward  side  of  ranges." 

Regarding  the  proportional  rainfall  during  the  two  rainy  seasons, 
a  record  of  ten  weather-stations*  (excluding  Yuma)  gave  a  total  pre- 
cipitation for  the  winter  months  (December,  January,  and  February) 
of  3.55  inches  ;  for  the  summer  season  (July,  August,  and  Septem- 

'  Captain  W.  A.  Glassford.  -  Captain  W.  A.  Glassford.  3  General  A.  W.  Greely. 

^  The  ten  stations  were  Fort  Apache,  Calabesas,  Crittenden,  Fort  Defiance,  Fort  Grant,  Hua- 
chuca,  Phoenix,  Tucson,  Prescott,  and  Verde.    Their  average  elevation  is  3900  feet. 


292  MEDICAL  CLIMATOLOGY. 

ber),  7.71  inches.  Total  for  the  entire  year,  14.67  inches.  The 
mean  annual  rainfall  for  the  whole  territory  is  11  inches.^ 

The  belt  of  mean  annual  temperature  of  60^  follows  nearly  the 
line  of  3000  feet  elevation.  It  runs  north  of  Fort  Thomas,  Globe, 
Gillette,  and  Signal — except  for  a  narrow  strip  which  runs  up  the 
valley  of  the  Rio  Verde,  penetrating  into  the  higher  mesa.  The 
belt  of  50°  to  55°  ivean  annual  temperature  includes  Prescott,  Flag- 
staff, and  nearly  all  of  the  mesa  or  plateau  above  5000  feet. 

The  belt  of  50°  or  less  meau  annual  temperature  includes  the 
northeast  corner  of  the  territory  above  Fort  Defiance.  In  the 
southern  half  of  the  territory  the  mean  temperature  of  60°  or  more 
shades  into  the  heat  of  the  desert,  with  a  mean  annual  temperature 
of  about  70°  and  a  monthly  mean  for  July  of  90°. 

The  relative  humidity  will  average  about  the  same  percentage  as 
in  Kew  Mexico,  giving  a  little  over  2  grains  of  absolute  humidity 
to  the  cubic  foot. 

The  marked  dry  season  of  Arizona  is  in  the  spring  and  early 
summer  before  the  coming  of  the  cooling  summer-rains ;  but  the 
number  of  cloudy  days  during  the  autumn  and  during  the  year  i& 
fully  as  low — if  not  more  so — on  the  high  plateau  as  in  New 
Mexico  and  Colorado,  while  on  the  almost  rainless  desert  the 
number  of  cloudy  days  is  exceedingly  small. 

The  wind-movement  at  Prescott,  Fort  Grant,  and  Fort  Apache 
shows  an  annual  average  velocity  (for  four  and  six  years)  of  a  little 
under  7  miles  per  hour.  Phoenix  has  the  smallest  recorded  annual 
wind-movement,  averaging  about  2^  miles  per  hour. 

In  Buck's  Reference  Handbook  of  the  Medical  Sciences  the  article 
"Arizona,"  based  on  reports  of  surgeons  of  the  United  States  Army, 
states  that  "  the  exceptional  dryness  and  purity  of  its  atmosphere, 
the  wonderful  clearness  of  its  skies,  and  the  very  small  number  of 
rainy  days  there  occurring,  would  all  seem  to  point  to  the  desira- 
bility of  the  territory  of  Arizona  as  a  health-resort  for  patients 
suffering  from  pulmonary  phthisis  or  from  other  diseases  of  the 
respiratory  system.  .  .  .  The  climatic  advantages  of  Arizona 
are  almost  identical  with  those  to  be  found  in  New  Mexico." 

Arizona  is  sadly  destitute  of  large  modern  towns  where  satisfac- 
tory accommodations  for  invalids  can  be  relied  on.  In  all  the  vast 
country  there  are  but  two  or  three  towns  where  it  is  possible  to  get 

1  Rainfall  and  Snow  of  the  United  States.    Professor  M.  W.  Harrington,  Washington,  1894. 


ROCKY  MO UNTAIN  REGION.  293 

needful  supplies.  The  largest,  Phoenix  (1100  feet)  and  Tucson 
(2400  feet),  in  spite  of  their  fine  winter  climate,  leave  much  to  be 
desired  in  the  matter  of  modern  conveniences  and  accommodations 
for  visitors.  Prescott  (5300  feet)  is  even  more  poorly  equipped,  as 
it  has  been  losing  ground  for  several  years.  The  opening  of  the 
railroad  connecting  Phoenix  through  Prescott  with  the  main  line  of 
the  Santa  Fe  road  at  Ash  Fork  may  be  the  ra  ans  of  restoring  its 
commercial  prosperity.  Prescott  is  in  the  centre  of  a  fine  country, 
and  if  it  were  larger  and  more  prosperous  would  make  a  suitable 
place  of  residence  for  the  entire  year.  ; 

Near  Flagstaff  (7000  feet),  on  both  sides  of  the  railroad,  are  great 
forests  of  tall  pines.  It  is  a  park-like  country,  with  grazing-land, 
sandy  soil,  and  good  water  in  the  mountains.  Photographs  of  the 
plateau  show  picturesque  groups  of  pines  and  a  general  resemblance 
to  Estes  Park,  Colorado.  From  the  hills  south  of  Prescott  to  the 
forest-plateau  north  of  Flagstaff  the  altitude  varies  from  4000  to 
7000  feet.  In  many  of  the  canons  are  found  old  villages  of  the 
cliff-dwellers.     The  pines  rarely  grow  below  4000  feet. 

It  is  a  country  with  fine  possibilities,  which,  so  far,  are  utterly 
undeveloped.  Besides  its  climatic  advantages  this  locality  is  but  a 
few  miles  north  of  the  lower  and  warmer  Phoenix  fruit-country,  a 
change  to  which  may  be  advisable  in  the  course  of  winter,  while  the 
high  plateau  stretching  away  north  to  the  Grand  Canon  of  the  Col- 
orado makes  a  pleasant  summer  camping-ground ;  or  it  is  but  a 
couple  of  days'  journey  to  the  rainless,  pine-clad  slopes  of  the  Sierra 
Nevada  range  in  California. 

It  should  be  noted  among  Arizona's  peculiarities  that,  in  spite  of 
her  two  rainy  seasons,  the  annual  total  precipitation  is  no  more 
than  in  Colorado  or  New  Mexico,  while  the  spring  is  usually  dry 
and  there  are  but  few  cloudy  days  in  the  autumn. 

Prescott  (elevation,  5300  feet  ;  population,  3000 ;  latitude, 
34°  30'  north;  longitude,  112=  30'  west  from  Greenwich).  The 
town  of  Prescott  is  situated  a  little  to  the  west  of  the  centre  of 
Arizona  (on  the  Santa  Fe,  Prescott  and  Phoenix  Railroad),  sixty 
miles  beyond  Ash  Fork.  Its  geographical  position  is  in  some  re- 
spects unique.  Seventy  miles  to  the  northeast  is  the  San  Francisco 
range  of  mountains,  while  the  snow-clad  peaks  of  Humphrey, 
Agassiz,  and  Humboldt  rise  to  an  altitude  of  nearly  13,000  feet. 
Away  north  are  the  Coconimo  hills  and  the  great  canons  of  the 
Colorado  River,   where  the  surface  of   the  rushing  water  is  over 


294  MEDICAL  CLIMATOLOGY. 

6000  feet  below  the  level  of  the  plateau.  Through  this  country 
above  Prescott,  at  a  varying  elevation  of  6000  or  7000  feet,  are 
great  forests  of  pine  and  an  open  graziug-country.  It  is  a  land  of 
summer-rainfall  and  winter-snows.  Eighty  miles  to  the  south  are  the 
plains  of  the  Gila  and  Salt  Rivers,  which,  although  naturally  arid, 
have  been  so  cultivated  by  means  of  irrigation  that  Phoenix,  situated 
in  their  midst,  at  an  elevation  of  1100  feet,  is  surrounded  by  fertile 
fields  and  groves  of  oranges,  olives,  figs,  and  semitropical  fruit.  It 
may  be  said  that  Prescott  is  distant  but  an  hour  or  two  by  rail  from 
both  the  torrid  and  the  temperate  zones. 

Although  very  much  further  south,  Prescott  has  a  climate  re- 
sembling that  of  Denver,  which  has  the  same  elevation,  but  exceeds 
Prescott  slightly  in  the  number  both  of  very  hot  and  very  cold  days. 

The  high  plateau  and  mountains  of  Arizona,  lying  mostly  north 
of  latitude  34°,  have  "two  plainly  marked  rainy  seasons"^ — i.e., 
the  season  of  winter-rains  between  December  and  February  and  the 
summer-rains  of  July,  August,  and  part  of  September.  The  mean 
annual  rainfall  at  Prescott  for  eighteen  years  is  16  inches,  and  the 
record  for  that  time  shows  but  two  years  exceeding  20  inches. 

The  town  is  situated  on  Granite  Creek.  The  town-supply  of 
water  is  hard.  There  are  wells  of  softer  water  for  domestic  use. 
The  horizon  is  bounded  on  all  sides  by  distant  hills  and  mountains, 
which  afford  protection  from  cold  northern  storms  in  winter  and 
the  desert-heat  in  summer.  Near  by  are  the  pines,  which  offer 
especial  attraction  to  invalids.  These  trees  are  seldom  found  in 
Arizona  below  an  elevation  of  4000  feet.  The  pine-forests  are  most 
extensive  to  the  east  and  south  of  Prescott. 

Prescott  is  situated  in  a  gray-granite  country,  and  much  of  the 
soil  surrounding  the  town  is  of  a  sandy  nature,  drying  quickly 
after  a  rain.  The  town  itself  is  on  adobe-soil,  although  Whipple 
Barracks,  one  mile  from  the  plaza,  has  a  sandy  soil.  There  are 
windy  and  dusty  days  in  the  spring.  The  summers  are  hot,  but 
are  rendered  more  endurable  by  the  cooling  influences  of  afternoon 
rains.  Snow  falls  occasionally  during  the  winter,  but  the  direct  rays 
of  the  sun  rarely  allow  it  to  remain  long,  although  sleighing  has 
been  known  even  in  the  streets  of  Prescott.  The  climate  during 
the  autumn  and  winter  is  delightful.  It  is  an  American  town, 
with  few  adobe-dwellings. 

1  Climate  of  Arizona.    Captain  W.  A.  Glassford. 


ROCKY  MO UNTA IN  REGION.  295 

Accommodatious  are  poor.  The  hotel  is  principally  for  the  ac- 
commodation of  miners,  and  the  best  way  of  living  is  to  go  to  house- 
keeping. 

The  average  temperature  for  January  is  34°;  for  July,  74°;  year, 
53°  (means  for  thirteen  years).  Average  uumber  of  days  above  90°, 
21;  below  32°,  115. 

Cloudy  days,  51;  stormy,  69  (means  for  three  years). 

Average  annual  velocity  of  wind,  7  miles  per  hour. 

Phoenix  (elevation,  1100  feet ;  population,  10,000).  This  town 
has  become  favorably  known  as  a  winter-resort  of  low  altitude.  It 
is  situated  near  the  centre  of  the  great  Salt  River  Valley,  about  two 
miles  north  of  that  stream  and  twenty-eight  miles  (in  a  direct  line) 
north  of  Maricopa  Station,  on  the  Southern  Pacific  Railroad,  with 
which  it  is  connected  by  rail.^  Direct  railroad  communication  with 
the  Santa  Fe  Railroad  at  Ash  Fork  is  now  open.^  Phoenix  is  the 
present  capital  of  Arizona.  Its  growth  during  the  past  few  years  has 
been  phenomenal.  It  has  waterworks,  street-railways,  gas  and  electric 
lights,  seven  churches,  six  banks,  and  three  daily  newspapers.  Its 
accommodations  for  visitors  are  not  yet  of  a  high  standard,  and  its 
best  hotel  is  greatly  overcrowded  in  winter,  especially  when  the 
Legislature  is  in  session.    However,  two  new  hotels  are  being  built. 

The  streets  of  Phoenix  are  broad  and  level,  shaded  on  each  side 
by  rows  of  cottouwoods  and  willows.  Streams  of  water  flow  in  the 
ditches,  and  the  houses — which  until  lately  were  usually  built  of 
adobe — are  well  shaded  and  surrounded  by  grass  lawns. 

The  Salt  River  Valley  is  a  favored  region  for  the  cultivation  of 
fruit,  as  snow  seldom  or  never  falls,  and  the  rich  alluvial  bottom- 
lands yield  largely  under  irrigation.  Fruits  mature  one  or  two 
months  earlier  here  than  in  Southern  California,  and  a  great 
number  of  small  ranches  are  being  developed  since  the  completion  of 
the  Arizona  Canal.  In  order  to  show  the  character  of  the  climate  it 
may  be  stated  that  an  exhibit  of  the  valley's  products  sent  to  Chicago, 
December  15,  1894,  consisted  of  oranges,  lemons,  olives,  grape- 
fruit, peaches,  pears,  strawberries,  fi'gs,  watermelons,  muskmelons, 
ripe  tomatoes,  green  pease,  green  corn,  pomegranates,  almonds, 
etc.;  also  alfalfa,  broom-corn,  sorghum,  sweet  potatoes,  squashes, 
pumpkins,  etc.  These  were  gathered  outdoors  in  the  month  of 
December. 

1  The  Resources  of  Arizona.    P.  Hamilton. 

-  The  Santa  Fe,  Prescott  and  Phcenix  Railroad. 


296  MEDICAL  CLIMATOLOGY. 

lu  the  matter  of  summer-heat  this  country  rivals  the  famous  Yuma 
Valley. 

The  average  temperature  (from  records  for  twelve  years)  is  for 
January,  49°;  for  July,  90°;  for  the  year,  69°.  By  seasons  it  is 
as  follows:  winter,  51°;  spring,  67°;  summer,  87°;  autumn,  69°. 
The  mercury  frequently  rises  to  95°  in  March  and  sometimes  to  100° 
in  April,  while  during  the  summer  months  the  heat  is  intense. 
Kecords  of  the  humidity  were  not  obtainable,  but  the  atmosphere 
is  considered  dry. 

The  average  annual  rainfall  is  7  inches.  The  amount  falling  in 
each  month  is  light,  the  heaviest  rainfall  occurring  in  August  and 
December.  The  average  annual  wind-movement  (taken  from  obser- 
vations for  three  years)  is  2^  miles  per  hour.^  General  A.  W. 
Greely  says  that  ''  Phoenix  is  the  locality  where  the  wind  is  per- 
haps the  feeblest  of  any  point  in  the  arid  regions."^ 

Tucson  (elevation,  2400  feet ;  population,  6000).  An  old 
Spanish  grant  is  said  to  show  a  Spanish  town  here  in  1553,  built 
on  the  site  of  an  Indian  pueblo  which  is  lost  in  the  mists  of  tra- 
dition. Another  account  dates  the  Spanish  Mission  of  San  Xavier 
from  1694.  At  any  rate,  in  the  words  of  a  thoughtful  writer, 
"it  is  certainly  of  sufficient  age  to  promise  permanence."^ 

The  name  is  said  to  be  from  an  Indian  word  pronounced  ''Chook- 
son,"  meaning  "Black  Water"  or  "Black  Creek". 

With  the  exception  of  one  or  two  public  buildings  and  mercan- 
tile structures  and  a  few  residences  of  better  style,  the  houses  are 
built  of  adobe,  one  story  in  height,  and  arranged  after  the  usual 
Mexican  fashion.  The  town  is  situated  on  the  Santa  Clara  plateau, 
and  is  surrounded  by  mountains.  On  the  north  are  the  Santa  Cata- 
linas,  east  the  Rincons,  south  the  Santa  Ritas,  and  on  the  west  the 
Tucson  range,  with  its  most  prominent  peak — Tucson  Mountain. 
The  plateau  is  about  twenty  miles  wide.  Water  is  brought  from  a 
point  on  the  Santa  Cruz  River,  seven  miles  distant.  The  winter 
climate  has  been  highly  praised  for  its  warmth  and  sunniness. 

The  average  temperature  for  January  is  50°;  for  July,  88°;  for 
the  year,  69°  (means  for  fourteen  years).  "The  mercury  is  never 
below  90°  at  2  p.m.  in  July,  aud  the  mean  minimum  for  that  month 
is  78°,  indicating  nights  too  hot  for  comfort.      ...     On  twenty- 

1  Report  ou  the  Climate  of  Arizona.    Captain  W.  A.  Glassford. 

-  Report  on  the  Climatology  of  the  Arid  Regions.    General  A.  W.  Greely. 

3  Arizona.     Honorable  John  A.  Black. 


ROCKY  MOUNTAIN  REGION.  297 

fiv^e  of  the  thirty-one  days  in  January,  1878,  the  mercury  fell  to  the 
freezing-point,  the  lowest  point  being  24°.'"  In  1892  the  lowest 
points  touched  were  :  January,  17°;  February,  30°;  December,  16°. 
These  low  night-temperatures  preclude  the  successful  cultivation  of 
semitropical  fruit,  which  is  so  large  an  industry  in  Phoenix  and 
Yuma,  but  the  winters  are  considered  mild  and  desirable  for  in- 
valids. The  best  part  of  the  season  is  from  December  to  April,  as 
after  that  it  grows  too  hot  for  comfort.  For  the  year  1892  the 
highest  temperatures  were:  in  May,  100°;  June,  107°;  July,  106°; 
August,  107°;  September,  102°.  The  average  number  of  days 
above  90°  is  128;  below  32°,  33;  cloudy  days,  57;  stormy  days, 
42  (means  for  two  years). 

The  record  by  season  is  shown  in  the  following  table,  the  figures 
for  temperature  and  rainfall  being  based  on  the  reports  of  the  army- 
posts  for  fourteen  years  r 


Temperature. 

Rainfall. 

Relative  humidity. 
1892. 

Winter 

.     52° 

3.01  inches. 

52  per  cent. 

Spring 

.     67 

1.22      " 

34 

Summer    . 

.     87 

5.47      " 

27 

Autumn    . 

.     70 

2.41       " 

32 

Year         ...     69  12.11       "  36 

The  accommodations  for  invalids  are  not  very  desirable. 

Tucson  is  on  the  main  line  of  the  Southern  Pacific  Kailroad,  and 
there  are  through  trains  east  and  west  daily. 

See  meteorological  data  for  Fort  Grant  (4860  feet),  sixty-odd  miles 
northeast  of  Tucson,  page  299. 

Oracle.  Elevation,  4500  feet.  This  settlement  is  forty  miles 
north  of  Tucson,  by  a  good  road.  It  is  less  than  one  day's  journey 
by  stage.      The  population  numbers  twenty-five  or  thirty  persons. 

Oracle  contains  three  or  four  ranches,  two  of  which  take  boarders. 
The  accommodations  are  good  for  the  Southwest. 

The  soil  is  a  granitic  detritus.     There  is  no  adobe. 

Good,  soft  drinking-water  is  obtained  from  wells.  There  are  live- 
oak  trees,  and  pines  grow  further  up  the  mountains,  eight  or  ten  miles 
away.  The  great  mountain-ranges  afford  shelter  from  northern 
storms. 

1  Handbook  of  the  Pacific  Coast.    Dr.  J.  S.  Hittell. 

-  Report  on  the  Climate  of  Arizona.    Captain  W.  A.  Glassford. 


298  MEDICAL  CLIMATOLOGY. 

There  are  no  springs  or  streams  of  water  immediately  around 
Oracle,  but  within  convenient  reach  for  exploring  are  said  to  be 
interesting  canons  and  attractive  scenery. 

The  winter-climate  is  dry,  warm,  and  mild.  There  is  little  or  no 
dust. 

Yuma  (elevation,  140  feet ;  population,  1200).  During  the 
winter  months  there  is  probably  no  place  near  the  sea-level  where 
as  mild  and  dry  a  climate  can  be  found  as  in  Yuma,  which  is  situ- 
ated in  the  Great  Arizona  Desert,  on  the  banks  of  the  Colorado  River, 
fifty  or  sixty  miles  above  the  salt  water  of  the  Gulf  of  California. 

Early  semitropical  fruit  can  be  grown  on  the  soil  watered  by  the 
Colorado  River,  and  this  industry  is  one  that  will  probably  be 
extensively  developed,  as  the  fruit  ripens  earlier  here  than  in  Cali- 
fornia. 

Yuma  is  famed  for  sunshine  and  heat,  the  latter  being  a  delicate 
subject  to  refer  to  local  opinion.  The  mean  monthly  temperature 
for  January  is  53°;  for  July,  92°;  for  the  year,  72°  (from  observa- 
tions for  fourteen  years).  The  mean  of  the  minima  for  three  years 
(1891-93)  for  July  is  75°  and  for  August  77°,  indicating  hot  nights. 
The  average  number  of  days  during  the  year  above  90°  is  163  ;  be- 
low 32°,  4  ;  cloudy  days,  21  (mean  for  six  years). 

The  mean  monthly  winter-temperature  for  Yuma  is  56°.  The 
maximum  temperature  is  likely  to  exceed  100°  during  the  months 
of  May  to  October,  iuclusiv^e.  Frequently  it  exceeds  100°  in  April, 
and  it  mav  rise  to  90°  during  the  month  of  March.  In  1893,  from 
April  to  October,  inclusive,  out  of  214  days  162  days  were  over 
90°.     The  maximum  temperature  for  the  year  was  111°. 

Physical  suffering  is  not  so  great  under  this  intense  heat  as  it 
would  be  if  it  were  not  for  the  great  dryness  of  the  desert-air  and  the 
consequent  rapid  evaporation.  The  sensible  temperature  (wet-bulb 
thermometer)  is,  however,  frequently  over  80°,  which  would  any- 
where be  considered  hot. 

The  yearly  mean  of  the  relative  humidity  is  46  per  cent. 

The  present  hotel-accommodatious  are  ordinary.  The  Southern 
Pacific  Railroad  has  for  several  years  been  reported  to  have  in  con- 
templation the  erection  of  a  good-sized  hotel. 

There  is  little  amusement  in  Yuma,  as  there  are  few  objects  of 
interest  in  the  vicinity. 

An  army-post — Fort  Yuma — is  situated  on  the  opposite  side  of 
the  Colorado  River,  in  the  State  of  California. 


ROCKY  MOUNTAIN  REGION.  299 

Army-posts  and  Other  Stations/  Fort  Defiance  (elevation, 
6500  feet)  is  situated  iu  the  northeastern  portion  of  Arizona,  near 
the  line  of  New  Mexico.  It  is  in  the  belt  of  mean  annual  teaipera- 
ture  of  45°  to  50°,  and  is  an  elevated  country  with  forests  and 
springs  and  a  climate  resembling  the  Colorado  plains.  Due  north 
of  Fort  Defiance  are  the  Moqui  and  Navajo  Indian  Reservations. 

Autumn.      Winter.      Spring.      Summer.         Year. 
Temperature^  (8  years)      46°  27°  46°  68°  47° 

Rainfall  (7  years)    3.72  in.  2.55  in.    2.03  in.     5.89  in.     14.19  in. 

Fort  Apache  (elevation,  5000  feet).  This  post,  like  Fort 
Grant,  is  near  the  old  Apache  Indian  Reservation.  The  country 
generally,  though  sparsely  settled,  is  devoted  to  sheep-  and  cattle- 
raising  and  agriculture.  About  thirty  miles  northeast  of  Fort 
Apache  are  the  White  Mountains,  which  are  said  to  possess  fine 
natural  scenery.  They  lie  within  one  of  the  rainfall-belts  of  20 
inches  for  the  year,  of  which  there  are  four  or  five  in  Arizona. 
There  are  pine-forests  and  beautiful  parks  and  valleys.  Game  and 
fish  are  plentiful. 

Autumn.     Winter.      Spring.      Summer.       Year. 
Temperature  (18  yrs.)        54°  37°  52'-  73°  54° 

Rainfall  (15  yrs.)     3.05in.     5.07in.     2.96in.    8.96in.    20.04in. 

Wind-movement,  annual  average,  6|  miles  an  hour. 

Relative  humidity,  annual  average,  46  per  cent. 

Fort  Grant.  Elevation,  4860  feet.  Sixty  or  seventy  miles  north- 
east of  Tucson,  in  the  foot-hills  of  the  Graham  Mountains.  It  is  a 
military  post,  with  commodious  quarters  for  officers  and  men,  hos- 
pital, waterworks,  store,  postoffice,  ice-machine,  etc.  There  is  tele- 
graphic communication  with  Fort  Thomas. 

Autumn.     Winter.      Spring.      Summer.      Year. 
Temperature  (17  yrs.)        62°  45°  59°  77°  61° 

Rainfall  (16  yrs.)     3.64  in.     3.68  in.     1.80  in.    7.73  in.   16.85  in. 

Wind-movement,  annual  average,  7  miles  per  hour. 
Average  number  of  days  above  90°,  40  ;  below  32°,  29  (for  two 
years).     Mean    monthly   temperature — January,    44";    July,    79°. 

1  Tliese  army-posts  are  mentioned  on  account  of  ttieir  fine  climate,  and  the  illustration  they 
aflFord  of  the  natural  resources  of  the  hill-country  of  Arizona.  It  would  be  important  for  a 
casual  visitor  to  be  provided  with  proper  letters  of  introduction  to  some  of  the  higher  army 
officers,  before  venturing  so  far  away  from  ordinary  hotel-accommodations,  as  there  is  usually 
no  settlement  of  any  size  near  the  post.  It  may  be  added  that  on  the  frontier  it  is  often  diffi- 
cult to  supply  two  of  an  invalid's  greatest  needs— fresh  meat  and  milk.' 

-'  From  Report  on  Climate  of  Arizona,  etc.,  by  Captain  W.  A.  Glassford,  Signal  Corps,  U.S.A. 


Spring. 

Summer. 

Year. 

61° 

80° 

61° 

1.98  in. 

4.88  in. 

13.18  in. 

300  MEDICAL  CLIMATOLOGY. 

Mean  annual  relative  humidity,  45  per  cent.  Absolute  humidity, 
2.38  grains.  Average  number  of  cloudy  days  per  annum,  45. 
(These  last  three  records  for  ten  years.) 

Fort  Verde.  Elevation,  3200  feet  ;  population  about  50(?). 
Forty-five  miles  east  of  Prescott.  Situated  near  the  Rio  Verde. 
Camp  Verde  has  a  pretty  location.  It  now  consists  largely  of 
abandoned  adobes.     Cotton  wood-trees  grow  near  the  river. 

Hittell's  Handbook  of  Pacific  Coast  Travel  divides  the  year  into 
two  periods  of  six  months  each,  and  reports  the  relative  humidity 
of  Camp  Verde  as  follows:  cold  seme.ster,  41  per  cent.;  warm 
semester,  38  per  cent.     Average  for  the  year,  40  per  cent. 

Autumn.     Winter. 
Temperature  (21  yrs.)         61°  43° 

Rainfall  (21  yrs.)     2.82  in.     3.45  in. 

Tombstone  (elevation,  2300(?)  feet ;  population  about  2500(?)). 
The  town  is  built  on  an  elevated  mesa  on  the  San  Pedro  River, 
twenty-eight  miles  south  of  Benson,  on  the  Southern  Pacific  Rail- 
road, and  eight  miles  from  Fairbanks,  on  the  Xew  Mexico  and 
Arizona  Railroad.  The  buildings  are  largely  adobe,  one  .story  in 
height,  with  arcades  shading  the  sidewalks.  The  natural  facilities 
for  town-drainage  are  said  to  be  good.  An  ample  supply  of  pure 
water  is  brought  twenty-two  miles  from  the  Huachuca  Mountains. 

Autumn.     Winter.      Spring.      Summer.       Year. 
Temperature,  62°  46°  65°  77°  62° 

Rainfall,  for  the  year,  about  16  inches  (see  Fort  fluachuca). 

Port  Huachuca  (elevation.  4780  feet)  is  one  of  the  most  im- 
portant military  posts  in  Arizona.  It  is  situated  in  the  Huachuca 
Mountains,  at  an  altitude  where,  as  a  rule,  the  summers  are  cool  and 
pleasant.  There  are  picturesque  mountain-views  and  forests  of  pine- 
timber  in  the  vicinity.  Fort  Huachuca — and  also  the  settlement  of 
Huachuca,  ten  miles  north — are  near  the  influence  of  the  belt  of  20 
inches  annual  rainfall,  which  lies  over  the  Santa  Rita  Mountains. 


Autumn. 

Winter. 

Spring. 

Summer. 

Year. 

Temperature  (4  yrs.) 

61° 

44° 

59° 

76° 

60° 

Rainfall          (5  yrs.) 

4.57  in. 

3.02  in. 

1.20  in. 

7.60  in. 

16.39  in. 

In  this  corner  of  the  territory  are  several  other  well-situated  settle- 
ments of  high  altitude  on  the  line  of  the  Xew  Mexico  and  Arizona 
Railroad,  which  runs  into  Mexico.  In  the  mountains  are  a  num- 
ber of  picturesque  canons.      The  country,  unlike  the  low,  desert  por- 


ROCKY  210  UNTAIN  REGION.  30 1 

tioa  of  Arizona,  is  green  and  fertile.  There  are  fine  mountain-scenery 
and  pine-timber  on  the  ridges.  It  is  not  thickly  settled ;  the  prin- 
cipal occupations,  aside  from  mining,  are  grazing  and  fruit-raising. 

The  rivers  rise  in  the  higher  mountains  in  Mexico  and  flow  north 
to  the  Gila. 

Crittenden  (41 00  feet)  has  fine  natural  scenery  and  productive  fruit- 
farms.  Old  Camp  Crittenden  (2000  feet)  has  an  annual  average 
temperature  of  60°  and  an  annual  rainfall  of  16  inches.  It  is  near 
the  Senorita  Canon,  in  which  are  hot  springs.  At  Calabasas  (about 
4000(?)  feet)  the  views  of  the  mountains  are  extensive.  There  is 
said  to  be  hunting  in  the  vicinity.  There  is  a  brick  hotel  at  Cala- 
basas, with  some  modern  conveniences.  Nogales  (4000  feet)  is  on 
the  Mexican  line.  Transfer  is  here  made  to  the  Sonora  Railroad, 
running  to  Homosillo  and  Guaymas.  Nogales  is  an  American  town 
with  some  Mexican  characteristics.  It  claims  a  population  of  2000. 
The  buildings  are  mainly  adobe.  It  lacks  many  facilities  for  com- 
fortable living,  and  is  not  exempt  from  dust-storms.  The  soil  is 
sandy  loam,  which  dries  rapidly  after  rains.  The  climate  is  fine, 
sunny,  and  mild,  though  somewhat  warm.  The  rainfall  is  about 
10  inches  a  year. 

Springs. 

The  foot-hills  and  valleys  of  Arizona,  in  or  near  the  "  rain-islands  " 
before  alluded  to,  are  supplied  with  mineral  springs — both  hot  and 
cold — but  they  have  not  been  developed,  and  so  little  is  known  of 
them  that  any  reference  to  the  springs  of  Arizona,  at  this  day,  is 
necessarily  meagre  and  incomplete.  In  the  hilly  country  between 
Prescott  and  Phoenix  are  numerous  springs.  The  Rio  Yerde  is 
formed  from  a  series  of  springs  in  what  is  known  as  Chino  valley, 
in  the  Great  Colorado  plateau,  between  the  Jupiter  range  and  Bill 
Williams's  Mountain.  In  the  Verde  valley  is  the  Montezuma  well, 
near  which  is  a  warm  soda  spring.  The  Castle  Creek  Hot  Springs, 
in  the  southern  part  of  Yavapai  County,  have  been  much  visited  by 
invalids.  Twenty  miles  or  so  below  Phoenix,  on  the  Gila  River,  are 
hot  medicinal  springs,  well  known  to  the  Indians.  The  streams 
rising  in  the  mountains  in  the  eastern  portion  of  Arizona  are  fed  by 
numerous  cold  springs.  Near  Wilcox  (Cochise  County)  are  Hooker's 
Hot  Springs,  consisting  of  a  cold  sulphur  spring  and  six  hot  springs, 
in  which  magnesia  and  iron  are  said  to  predominate. 


CHAPTER    XIV. 

PACIFIC  SLOPE   EEGION. 

The  Climate  of  Southern  California. 

"  Two  influences  dominate  the  climate  of  California,  radically  dis- 
similar in  every  particular,  combining  in  ever-varying  forces  to  pro- 
duce the  resultant  which  is  recorded  by  observers  of  the  weather. 
One  is  the  sea,  tending  always  to  charge  the  air  with  moisture ;  the 
other  is  the  mountain-mass,  tending  always  to  discharge  the  moisture 
from  the  air.  The  combination  of  these  two  activities  in  varying 
proportions  is  responsible  for  the  variation  in  the  amount  of  precipi- 
tation, including  months  of  drought.'" 

The  important  mountain  factors  are  the  great  chain  of  the  Sierra 
Nevada  and  the  Coast  Range.  In  the  southern  portion  of  the  State 
is  a  third  series  of  elevations  which  may  belong  to  either  of  the 
other  northern  systems,  and  which  has  been  distinguished  as  the 
Southern  Coast  Range.  It  extends  from  the  Tehachapi  region 
southeasterly  to  San  Bernardino  Peak  and  Grayback,  the  altitudes 
of  which  approximate  to  12,000  feet.  South  of  these  peaks  the 
range  runs  parallel  to  the  coast  into  Lower  California. 

It  is  with  Southern  California  that  we  have  principally  to  do. 
That  portion  of  the  State  south  of  latitude  35°  lies  more  open  to  the 
sea.  The  hills  no  longer  form  a  barrier  to  the  wind  directly  over 
the  shore.  They  are  here  further  inland,  and  leave  large  and  beautiful 
fertile  valleys  accessible  to  the  daily  ocean-wind.  Among  these  are 
the  Santa  Inez  and  Santa  Monica  and  the  rich,  broad  valleys  of  Los 
Angeles  ;  the  fertile  district  extends  through  the  valley  of  San  Gabriel 
and  as  far  as  that  of  the  Santa  Ana.  It  includes  Riverside,  Colton, 
Pomona,  and  the  long  plains  of  the  San  Jacinto,  stretching  south- 
ward to  the  valleys  of  San  Diego,  while  facing  directly  upon  the 
sea  are  the  valleys  of  the  Santa  Clara  and  Santa  Buena  Ventura 
and  the  Santa  Barbara  plains.     These  inland  tracts  of  country  are 

1  Climate  of  California  and  Nevada,'with  Particular  Reference  to  their  Rainfall  and  Temper* 
ature,  etc.,  by  Captain  W.  A.  Glassford,  Signal  Corps,  U.  S.  A. 


PACIFIC  SLOPE  REGION.  303 

irregular  in  outline,  branching  out  in  many  directions  and  often 
merging  into  rolling  upland  mesa>i. 

Dr.  J.  P.  Widney  says,  in  his  able  and  entertaining  Climatology 
of  the  Pacific  Coast  :^  "  The  area  of  the  plains  of  Southern  California 
is  really  largely  increased  over  their  apparent  size  by  the  rolling,  hilly 
uplands  into  which,  in  many  directions,  they  merge.  This  is  espe- 
cially the  case  in  the  country  which  lies  between  the  San  Fernando 
valley  and  the  lower  Santa  Clara  valley,  and  also  in  the  great  upland 
which  rises  from  San  Jacinto  toward  the  south  in  San  Diego  County. 
These  uplands  have  a  rich,  deep  soil,  and  are  well  watered  by  numer- 
ous small  streams." 

Directly  north  and  east  of  the  highest  part  of  the  Southern  Coast 
Range  are  the  great  deserts.  The  Mohave  Desert  has  an  average 
elevation  of  about  2000  feet.  In  the  southeasterly  corner  of  the 
State,  bordering  on  the  Colorado  River,  is  the  low  desert-land  called 
the  Colorado  Desert,  which  in  some  places  is  depressed  nearly  300 
feet  below  the  level  of  the  sea. 

The  influence  of  these  vast  desert-areas  on  the  country  to  the 
windward  of  the  mountains — that  is,  on  the  fertile  plains  south  and 
west  of  the  ranges — is  plainly  perceptible. 

Besides  the  influences  of  the  mountain-masses  in  aiding  to  dis- 
charge the  moisture  from  the  atmospliere,  another  influence  has  been 
referred  to  as  constantly  exerted  to  charge  the  atmosphere  with 
moisture,  namely,  the  Paciflc  Ocean  influence. 

In  his  elaborate  and  comprehensive  memoir  of  the  California 
climate,  which  is  full  of  scientific  detail,  Captain  Glassford  has 
placed  bounds  around  that  part  of  the  North  Pacific  Ocean  which 
may  be  considered  as  modifying  the  climate  of  California,  as  follows: 
''To  the  west  it  is  bounded  by  the  extreme  Orient,  the  islands  of 
Japan,  with  their  northern  projection  over  the  Kuriles  to  the  coast 
of  Kamtchatka  and  their  southerly  connections  with  the  Philippines. 
The  northern  limit  is  drawn  by  the  Aleutian  Islands,  and  the  eastern 
border  is  the  shore  of  North  America.  To  the  south  no  consistent 
mass  of  land  appears  to  hem  this  ocean  in,  yet  the  barrier  is  none 
the  less  strong  because  it  may  be  measured  only  with  the  instruments 
of  the  meteorologist.  It  exists  at  the  thirtieth  parallel  of  north  lati- 
tude. Below  this  bounding-liue  is  the  region  of  the  northeast  trade- 
wind  and  the  westward  drift  of  the  equatorial  current,  and  these 

1  California  of  the  South,  by  Walter  Lindley  and  J.  P.  Widney,  1888. 


304  MEDICAL  CLIMATOLOGY. 

two  serve  sufficiently  to  bound  in  wind  and  water  the  great  basin 
above." 

It  is  a  basin  within  these  limits — a  rough  ellipse  having  a  major 
axis  of  100°  of  longitude  aud  a  minor  axis  of  25°  of  latitude.  It  has 
its  characteristic  systems  of  circulation,  both  of  atmosphere  and  sea. 

The  strongly  individualized  ocean-current  of  the  region  is  the 
Kurosiwo.  Developed  from  the  culraiuative  process  of  the  equa- 
torial drift  and  directed  by  the  rapid  alteration  in  the  plane  of  the 
sea-bottom  and  the  trend  of  the  Asiatic  coast,  this  warm  stream 
moves  across  the  whole  Northern  Pacific.  Flowing  through  a 
broader  sea  than  does  the  Gulf-stream,  it  shows  several  important 
differences — it  has  a  slower  motion,  its  warmth  is  not  in  such  strong 
contrast  to  the  water  through  which  it  flows,  and  the  wind  blowing 
counter  to  its  course  frequently  avails  to  deflect  it  or  even  to  check 
it  entirely.  Its  eastern  development  and  dispersion  have  been  for 
years  a  battle-ground  for  theorists,  and  even  now  it  is  impossible  to 
say  definitely  that  it  reaches  any  part  of  the  Californian  coast. 

The  winds  upon  this  basin  are  of  the  system  of  the  passage-winds 
which  are  developed  upon  the  surface  of  the  earth  by  the  descent 
from  high  altitudes  of  upper  currents.  In  general  these  winds  vary 
with  the  latitude  from  southwest,  westerly,  to  northwest.  It  should 
be  noted  that  these  winds  begin  to  appear  about  the  parallel  of  30° 
north,  aud  that  at  first  they  are  practically  dry  winds,  but  present- 
iug  all  the  best  conditions  for  absorption.  The  sea  is  warm  and  in 
the  best  condition  for  giving  off  moisture,  and  the  wind  is  most 
receptive.  ^ 

1  lu  order  to  gam  a  broader  view  of  the  distinctive  climate  of  California— which  diflfers  from 
that  of  any  district  in  this  country— it  may  be  well  to  quote  here  Captain  Glassford's  technical 
review  of  the  climatic  characteristics  which  dominate  the  whole  region  : 

"The  distinguishing  characteristic  of  the  climate  of  the  region  is  that  varieties  of  weather 
endure  practically  unaltered  for  days  at  a  time,  and  even  when  supplanted  by  others  return 
again  and  again,  and  on  each  such  recurrence  are  symmetrical  with  their  former  appearance, 
even  when  they  are  not  practically  identical.  In  this  regard  there  is  a  wide  variation  from 
the  conditions  which  obtain  elsewhere  in  the  United  States.  Nor  is  this  the  only  diflference. 
Another  notable  one  is  that  the  storms  of  the  Pacific  are,  with  comparative  infrequency,  traced 
across  into  the  Central  Valley  and  the  Atlantic  Slope.  Another  is  that  the  storm-area  fre- 
quently increases  rapidly  toward  the  north. 

"When  the  area  of  low  barometer  of  considerable  depth  overlies  Oregon  and  Washington, 
and  probably  is  central  far  to  seaward,  and  the  cyclonic  type  appears,  its  translation  eastward 
is  checked  if  not  prohibited  by  the  barrier  of  the  Cascade  Range  and  the  Rocky  Mountains, 
which  here  begin  to  fuse.  Held  back  by  the  mountain-wall  and  the  equally  potent  barrier 
of  high  pressure  eastward,  the  low  is  kept  beating  against  these  obstaclesand  the  high  remains 
steadfast  over  the  Great  Basin*  and  the  Northern  Plateau.    While  this  condition  endures  gales 


*  The  Great  Basin,  a  high  plateau  lying  between  the  Sierra  Nevada  and  the  Wasatch  Moun- 
tains. It  contains  208,500  square  miles,  embracing  all  of  Nevada  and  Western  Utah,  and  por- 
tions of  the  adjoining  States. 


PACIFIC  SLOPE  REGION.  305 

are  felt  upon  the  Californian  coast  as  far  down  as  Cape  Mendocino,  and  rain  occurs  in  the 
Great  Valley*  and  down  the  coast  to  San  Luis  Obispo.  These  storms  leave  the  southern  part 
of  the  State  untouched,  except  when  a  subsidiary  low  is  developed  over  the  Colorado  Desert, 
when  the  brief '  Sonora  storms  '  occur." 


*  The  Great  Valley.  This  term  includes  both  the  Sacramento  and  San  Joaquin  Valleys.  It 
has  a  length  of  about  450  miles  by  about  40  miles  average  width,  taking  in  the  lower  foot-hills. 

"  When  this  lower  area  is  shallower,  and  can  be  plainly  seen  to  have  its  centre  not  far  out 
upon  the  sea.^but  over  Washington,  and  the  high  is  plainly  marked  upon  the  Great  Basin,  then 
occur  light  showers  from  San  Francisco  northward,  with  strong  gales  at  Cape  Mendocino  ;  the 
temperature  over  the  dry  area  is  usually  high  and  occasionally  of  steep  gradients,  and  in  the 
Los  Angeles  region  the  warm  Santa  Ana  winds  occur.  The  rain  rarely  passes  south  of  San 
Francisco,  except  in  cases  where  the  definition  of  the  high  is  so  strong  toward  the  south  of  the 
Great  Basin  as  to  condition  a  low  advancing  over  the  Southern  Coast  Ranges  and  back  of  the 
Sierras  to  meet  it ;  then  light  showers  may  occur  between  San  Luis  Obispo  and  San  Diego. 

"  These  Iwo  cases  have  presented  the  conditions  ot  low  pressure  over  Washington  and  Oregon, 
accompanied  by  rains,  which,  for  the  most  part,  occur  in  California  only  in  the  region  north 
of  the  southern  inosculation  of  the  Coast  Range  and  the  Sierra  Nevada.  When,  on  the  other 
hand,  a  high  area  rests  upon  the  two  Northern  States  and  the  low  type  is  permanent  over 
Southern  California,  it  conditions  for  California  a  climatic  manifestation  of  extremely  unstable 
equilibrium,  and  while  this  arrangement  of  the  meteoric  elements  is  of  frequent  occurrence  it 
is  often  of  short  duration.  When  the  low  is  in  the  north  rain  falls  upon  California ;  when  the 
high  is  in  the  north  fair  weather  is  a  marked  concomitant. 

•'  During  the  perfection  and  greatest  intensity  in  the  prevalence  of  this  arrangement,  and 
while  the  isobars  are  perpendicular  to  the  general  trend  of  the  coast-line  and  the  axial  inflec- 
tion of  the  Coast  Ranges  and  the  Sierra  Nevada,  the  Great  Valley  is  exposed  to  '  northers,' 
marked  with  disastrous  desiccating  influences.  The  day-temperature  is  usually  high,  increas- 
ing proportionally  to  the  duration  of  this  climatic  type,  but  at  night  frosts  are  of  character- 
istically frequent  occurrence.  The  winds  increase  toward  the  south,  being  light  and  variable 
on  the  Oregon  coast,  but  high  gales  on  the  Californian  coast.  When  this  type  occurs  in  spring, 
and  is  accompanied  in  Southern  California  by  high  winds  and  sandstorms,  rain  is  almost  cer- 
tain to  follow.  In  general,  the  breaking  up  of  this  type  is  heralded  by  frosts  of  more  or  less 
severity. 

"The  most  severe  and  general  rains  of  the  region  occur  in  co-ordination  with  a  general 
climatic  disturbance  over  the  whole  country.  To  the  eastward  there  is  a  series  of  waves  of 
abnormally  high  pressure  over  the  eastern  guiding-planes  of  the  Cordilleran  system,  reaching 
thence  across  the  Central  Valley  and  the  Appalachian  system  to  the  Atlantic  seaboard,  and 
everywhere  accompanied  by  severe  storms  and  intense  cold.  Upon  the  Pacific  coast,  in  corre- 
lation with  this  eastern  disorder,  the  barometer  drops  veryilow,  and  exhibits  rapid  fluctuations, 
with  remarkable  gradients  between  the  coast  and  the  interior,  the  rain-area  overspreads  all 
sections,  gales  are  marked  with  the  greatest  violence,  the  rivers  attain  their  high  levels  and 
tend  to  floods ;  in  general,  the  condition  is  that  of  an  extensive  cyclonic  disturbance,  which, 
proving  unable  to  scale  the  Sierra  Nevada,  is  forced  to  spread  out  over  the  entire  length  of  the 
coast  region,  until  it  gradually  wears  out  with  the  restoration  of  climatic  equilibrium  beyond 
the  range,  or  if  it  does  move  eastward,  does  so  at  some  extreme  point  beyond  the  sphere  of 
observation.  In  this  condition  of  the  weather  the  rain  is  precipitated  with  practical  impar. 
tiality  from  Siskiyou  to  San  Diego. 

"  Another  rainy  condition  is  found  when  a  diffuse  and  moderate  high  exists  upon  the  south- 
western coast,  accompanied  by  unusually  low  temperature,  and  apparently  unaflfected  either 
by  the  presence  or  the  absence  of  a  faint  and  shallow  low  on  the  Northern  coast.  With  this 
arrangement  of  climatic  factors  the  isobars  are  somewhat  perpendicular  to  the  coast,  a  condi- 
tion almost  certain  to  bring  rain,  while  if  these  curves  of  pressure  assume  a  parallelism  with 
the  coast-line  fair  weather,  soon  follows.  During  the  prevalence  of  this  condition  there  are 
rains  upon  the  Los  Angeles  country  and  the  Great  Valley,  and  the  winds  above  San  Francisco 
are  feeble,  except  in  the  rare  instances  when  the  barometer  sinks  excessively.  Should  the 
absolute  general  pressure  fall  considerably  below  the  normal,  yet  retaining  the  relative  high 
upon  the  southwestern  coast,  gales  rage  in  Southern  California,  with  occasional  storms  of 
thunder  and  hail.  This  condition  determines  very  suddenly  by  the  movement  of  the  high  up 
the  coast,  and  its  obliteration  as  a  distinct  feature  in  its  progress. 

"  A  condition  which  leads  to  rains  of  local  character,  yet  impartially  distributed  as  to  occur- 
rence within  geographical  limits,  is  marked  by  a  moderate  low  continued  through  a  succes- 
sion of  days  and  below  the  normal  over  a  large  area.   The  isobars  are  then  difi'usely  disrupted  ; 

20 


306 


MEDICAL  CLIMATOLOGY. 


Tlie  amount  of  annual  rainfall  along  the  southern  coast  and  on 
the  valleys  of  the  southern  slope  is  from  10  to  20  inches,  diminish- 
ing to  3  or  4  inches  over  the  Colorado  Desert  and  increasing  to 
about  40  inches  on  the  highest  summits/ 

The  period  of  the  winter-rains  is  seldom  established  before  No- 
vember, and  is  over  usually  by  April.  The  months  of  the  heaviest 
rainfall  are  December,  January,  and  February,  when  two  or  three 
inches  during  each  month  may  be  expected,  with  intervening  rain- 
less periods,  perhaps  several  weeks  in  length,  of  fine,  sunny  weather. 
In  Los  Angeles  over  60  per  cent,  of  the  rainfall  for  the  season  occurs 
during  these  three  winter  months.^ 

The  normal  rainfall  is  well  illustrated  by  the  following  table 
from  the  Government  records  for  each  of  the  months  of  the  rainy 
season  separately  and  the  remaining  six  months  of  the  year 
together. 

The  average  rainfall  for  these  three  towns  for  the  mouths  from 
November  to  April,  inclusive,  is  14  inches  ;  for  May  to  October, 
inclusive,  1.1  inch. 


Rainy  season, 
Southern  California. 

Nov. 

Dec. 

Jan. 

Feb.      March. 

April. 

iMay-Oct. 
inclusive. 

Length  of  record. 

Los  Angeles     .    .    . 
Santa  Barbara     .    . 
San  Diego    .... 

1.6 
1.6 
1.0 

3.7 
3.9 
2.1 

3.9 
3.7 
1.6 

4.0  j      2.2 
3.8            2.1 

2.1  1.0 

1.3 

1.4 
1.0 

1.2 
1.3 
1.0 

To  1S92,  21  years. 
"   1891,  24    " 
"   1892,42     " 

It  is  interesting  to  note  that  no  rainy  season  ever  runs  along  on 
normal  lines  in  California.  The  rain  may  hold  off  for  weeks  at  a 
time,  and  then  it  may  pour  for  days  and  days,  until  from  3  to  10 
inches  of  water  have  fallen  before  fair  weather  is  again  definitely 
restored.     It  is  of  great  value  to  know  the  annual  average  precipi- 


1  Irrigation  and  Rainfall  Maps.    William  Ham  Hall,  C.E. 

-  Rainfall  and  Snow  of  the  United  States.    Professor  M.  W.  Harrington,  Washington,  1894. 


they  are  wavy,  or  enclose  several  subsidiary  lows,  occurring  over  mountain-basins  with  a 
marked  absence  of  any  decided  gradients.  Tlie  winds  are  variable,  the  temperature  declines, 
the  sky  is  cloudy,  rain  comes  at  intervals,  rising  under  favorable  conditions  to  a  gale,  which, 
while  quite  local  in  character,  sometimes  does  considerable  damage  within  its  narrow  limits. 
"The  dry  season  shows  little  variation  from  beginning  to  end.  Rain  is  almost  entirely 
absent,  and  the  light  showers  which  sometimes  occur  on  the  Washington  coast  only  rarely  drop 
down  upon  a  limited  district  of  the  Californian  shore.  Another  feature  of  the  season  is  the 
development  and  persistence  of  marked  intensity  of  the  high  in  Oregon,  accompanied  with  a 
corresponding  fixity  of  a  slight  low  area  over  Southern  California,  creating  the  characteristic 
northerly  winds  which  blow  down  the  Great  Valley." 


PACIFIC  SLOPE  REGION.  307 

tation  for  twenty  years,  but  it  does  uot  in  the  least  indicate  what 
the  rainfall  will  be  for  the  coming  year.  Santa  Barbara,  with  a 
normal  precipitation  of  17.6  inches,  had  a  minimum  record  of  8.01 
inches  for  the  year  1881  and  a  maximum  of  38.8  inches  for 
1884.  Los  Angeles,  normal  18  inches,  has  varied  in  different  years 
from  5.6  inches  (1881)  to  40.5  inches  (1884).  Riverside,  normal 
10  inches,  has  had  minimum  2.46,  maximum  25.32  inches.  San 
Bernardino,  normal  16  inches,  has  had  minimum  8.98,  maximum 
37.51  inches.  San  Diego,  normal  10  inches,  has  had  a  minimum  of 
3.71  and  a  maximum  of  25.97  inches;  while  Julian,  with  a  normal 
of  38  inches  and  no  record  below  25  inches,  has  known  61.62  inches 
during  a  season.  One  of  the  heaviest  seasonal  rainfalls  in  Southern 
California  was  during  the  winter  of  1883-'84  when  previous  records 
were  everywhere  exceeded. 

Southern  California  has  been  divided  into  three  belts  of  mean 
annual  temperature:  (1)  A  belt  of  60°  to  68°  F.  along  the  seacoast 
and  extending  inland  from  thirty  to  fifty  miles.  (2)  A  belt  of  52° 
to  60°,  running  up  the  sides  of  the  Southern  Coast  Range  and  ex- 
tending from  Tehachapi  to  San  Bernardino  Peak  and  from  San 
Jacinto  Mountain  south  to  Lower  California.  (3)  A  wide  belt  of 
68°  to  78°,  beginning  at  the  base  of  the  mountains,  stretching  east 
and  northeast  to  the  Colorado  River,  and  including  the  Colorado 
and  Mohave  deserts. 

These  arbitrary  divisions  cannot  be  followed  closely,  however, 
as  every  valley  and  hillside  has  variations  both  of  temperature 
and  rainfall,  owing  to  its  position  with  relation  to  the  prevailing 
wind.  On  the  Coast  Range  this  variation  is  often  experienced. 
Dr.  Widney  says:  ''While  upon  the  ocean  side  of  the  range  are 
great  fore?ts  where  the  giant  redwood  is  bathed  nightly  in  the  dense, 
cool  fog  which  seems  to  be  essential  to  its  growth,  just  across  the 
summit  are  warm  mountain-slopes  facing  off  toward  the  morning 
sun,  their  rolling  hills  green  to  the  very  crest  with  the  olive  and 
the  vine;  and  yet  from  their  sheltered  warmth  one  may  pass  on  for 
a  few  miles  to  some  pass  or  gap  in  the  range  that  is  swept  during 
all  the  summer  months  by  the  great,  cool  ocean-wind  as  it  rushes 
through  to  the  heated  interior."^ 

The  relative  humidity  of  the  coast  is  usually  in  the  neighborhood 
of  70  per  cent.,  which,  taking  a  mean  annual  temperature  of  60°, 

1  California  of  the  South.    J.  P.  Widney,  M.D. 


308  MEDICAL  CLIMATOLOGY. 

would  show  the  amount  of  absolute  humidity  to  equal  4.03  grains 
of  vapor  to  each  cubic  foot  of  air.  This  humidity  decreases  steadily 
on  going  inland  until  the  desert  is  reached,  where,  east  of  the  moun- 
tains, the  atmosphere  is  perceptibly  drier.  It  is  here,  directly  within 
the  desert-influence,  that  any  dryness  in  California  is  to  be  found, 
for  within  the  sweep  of  the  sea-breeze  great  moisture  will  always  be 
present.  During  the  so-called  ''dry  "  or  rainless  summer  season  the 
relative  humidity  in  the  air  is  equal  in  amount  to  that  of  the  winter 
season,  as  shown  by  the  Government  weather-reports. 

The  Pacific  coast  has,  during  the  spring  and  summer,  a  frequent 
night-fog,  which  becomes  visible  about  sunset  or  a  few  hours  later 
and  disappears  during  the  early  forenoon. 

Many  observers  who  have  lived  directly  on  the  coast  believe  the 
fogs  to  be  more  frequent  during  the  winter,  especially  north  of 
Point  Concepcion ;  but  the  record  of  night  and  morning  fogs  at  Los 
Angeles  (fourteen  miles  from  the  sea)  for  thirteen  years  shows  that 
the  number  of  days  on  which  fogs  occur  increases  steadily  from  the 
beginning  of  spring  through  July,  continues  large  in  August  and 
September,  and  decreases  to  a  marked  degree  between  October  and 
March. 

By  seasons  the  average  number  of  foggy  nights  at  Los  Angeles  is 
as  follows  (means  of  thirteen  years)  -} 

Winter         .        .       7.3  days.        Summer  .         .         .     23.5  days. 
Spring.        .         .     12.1     "  Autumn  .         .         .     13.9     " 

Annual  average,  57  days. 

Owing  undoubtedly  to  local  conditions  Los  Angeles  is  more  sub- 
ject to  fog  than  San  Diego. 

In  1891  there  were  22  fogs  at  San  Diego,  the  greatest  number  in 
one  month  being  7,  which  occurred  in  November.  In  the  same 
year  there  were  62  fogs  at  Los  Angeles,  the  maximum  number  per 
month  being  reached  in  June  and  July,  in  each  of  which  there  were 
12  fogs. 

In  1893  there  were  12  fogs  at  San  Diego,  the  greatest  number  in 
one  month  being  3,  occurring  in  October;  while  there  were  46  fogs 
at  Los  Angeles,  11  of  which,  the  maximum  monthly  number,  come 
to  July. 

In  1894  there  were  26  fogs  at  San  Diego,  the  greatest  monthly 

1  From  records  of  Los  Angeles  office  of  U.  S.  Weather  Bureau. 


PACIFIC  SLOPE  REGION.  309 

number  being  9  in  November.  At  Los  Angeles  there  were  46  fogs, 
of  which  9  were  in  the  month  of  July,  8  in  August,  7  in  September, 
and  6  in  November.  Santa  Barbara  had  73  fogs  during  this  year, 
July  and  November,  during  which  months  they  were  most  frequent, 
having  16  and  12  respectively.  Records  for  other  years  were  not 
obtainable. 

In  Southern  California  a  fog  lasting  through  the  entire  day  is  in- 
frequent, the  usual  course  being  for  it  to  appear  in  the  night  and 
vanish  in  the  course  of  the  morning.  This  fog  is  a  virtual  prolonga- 
tion of  the  rainy  season  for  the  immediate  coast-district,  and  its 
humidity  and  freshness  help  to  make  the  day  cooler  and  more  brac- 
ing.    It  is  said  rarely  to  rise  above  an  altitude  of  2000  feet. 

Dr.  Widney  writes:  ''The  heat  of  the  summer  is  not  felt  along 
the  coast  within  reach  of  the  sea-breeze — a  midday  temperature  of 
65°  to  80°  being  the  rule,  varying  with  localities.  Back  from  the 
coast,  in  the  interior  valleys,  where  the  fog  does  not  penetrate,  the 
midday  temperature  may,  in  exceptional  cases,  during  a  hot  spell, 
reach  90°  or  100°  or  even  105°;  but  it  is  a  dry  heat,  without  the 
discomfort  or  danger  attending  a  like  temperature  in  the  Atlantic 
or  Mississippi  States.  These  hot  spells,  as  they  are  called,  may  occur 
several  times  during  the  course  of  the  summer,  generally  lasting  for 
three  days,  when  the  mercury  drops  and  the  normal  coolness  returns. 
Even  during  these  hot  spells,  however,  the  night  is  generally  marked 
by  a  rapid  fall  in  temperature,  so  that  sleep  is  restful  and  refresh- 
ing. The  heating  of  the  interior  valleys  gives  rise  during  the  after- 
part  of  each  summer-day  to  a  strong  surface-current  sea-breeze,  which 
dies  away  toward  sunset." 

As  the  cooler  air  from  the  sea  flows  in  upon  the  warmer  air  over 
the  land  the  moisture  in  the  warmer  air  is  condensed  into  visible 
vapor,  and  the  formation  of  fog  goes  rapidly  on.  Along  the  imme- 
diate coast  there  is  seldom  or  never  fog  on  the  land  unless  there  is 
also  fog  on  the  ocean,  and  while  there  is  little  wind  at  night  the  sea- 
influence  is  very  marked.^  In  some  of  the  interior  valleys,  however, 
the  light,  cool  evening-wind  which  blows  off  the  sides  of  the  moun- 

1  From  Report  of  Chief  of  U.  S.  Weather  Bureau,  1893. 
San  Diego.    Frequency  of  winds,  1893. 

Hours  winds  were  blowing  from  the  W.        2904  ;    E.       190 
"    N.W.    1677  ;     S.E.    256 

' S.W.     1522;    N.E.  704 

Total  sea-winds,  6103  hours  ;  total  land-winds,  1150  hours. 
As  is  usual  on  a  seacoast,  the  time  when  the  wind  is  blowing  from  the  land  toward  the  sea 
is  during  the  night. 


310  MEDICAL  CLIMATOLOGY. 

tains  performs  the  office  of  condensing  the  vapor  in  the  warmer 
strata  of  air  lying  over  the  plains.  Thus  a  fog  is  formed  which 
remains  until  dissipated  by  the  rays  of  the  sun  during  the  early 
forenoon.  But,  after  all,  the  source  of  the  fog  is  of  less  importance 
than  its  frequent  presence  and  the  fact  that  the  amount  of  moisture 
in  the  air  increases  with  the  approach  and  advance  of  night,  as 
shown  by  the  instruments  registering  that  factor.^ 

Dr.  Widney  continues  :  "  It  is  the  coolness  and  nightly  moisture 
of  these  summer-fogs  which  draw  the  frost-line  well  down  the  coast 
in  Northern  California.  To  persons  of  delicate  constitution,  those 
who  do  not  make  blood  and  bodily  heat  rapidly,  these  keen  sea- 
breezes  and  the  chill  fog  are  very  trying.  "- 

During  the  months  of  June,  July,  and  August,  which  are  the 
driest  months  of  the  year  in  California  away  from  the  coast,  any 
precipitation  is  rare  except  on  the  highest  mountains.  This  is  the 
time  of  year  for  camping-out  in  the  pines  on  the  sides  of  the  Sierras, 
4000  or  5000  feet  or  more  above  the  sea.  In  well-protected  spots 
there  is  little  if  any  dew,  and  the  relative  humidity  during  the 
middle  of  the  day  is  sometimes  as  low  as  20  per  cent.;  between  the 
1st  of  June  and  the  1st  of  September  there  is  little  danger  of  frost. 

In  the  fertile  valleys  during  the  rainless  season  the  irrigation  of 
groves,  orchards,  and  vineyards  is  constant  and  increases  with 
the  more  extender!  cultivation  of  the  soil.  How  great  an  effect 
this  practice  has  had  in  augmenting  the  rainfall  and  the  atmos- 
pheric humidity  is  yet  an  unsettled  question.  The  following  evi- 
dence is  submitted  as  suggestive,  the  first  illustration  especially: 

In  the  official  record  of  the  rainfall  at  Riverside  for  fourteen 
years,  from  1880  to  1893,  inclusive,  the  average  precipitation  of  the 
first  seven  years  is  8.02  inches  and  of  the  last  seven  years  11.75 
inches,  an  increase  of  46  per  cent.  Looking  at  it  in  another  way, 
the  annual  rainfall  at  Riverside  for  the  four  years  1880-'83,  inclu- 
sive, averaged  4.42  inches;  while  for  the  four  years  1890-'93  it 
was  10.69  inches,  an  increase  of  140  per  cent,  in  ten  years. 

The  record  of  Santa  Barbara  for  twenty-four  years,  from  1867 
to  1891,  gives  the  average  precipitation  of  the  first  twelve  years  as 
15.78  inches  and  of  the  last  twelve  years  as  20.50  inches,  an  in- 
crease of  32  per  cent.  The  question  of  irrigation  does  not,  how- 
ever, enter  into  the  discussion,  so  far  as  Santa  Barbara  is  concerned. 

1  See  p.  313.  2  CaUfomia  of  the  South.    J.  P.  Widnev. 


PACIFIC  SLOPE  REGION.  311 

The  cloudy  days  in  Southern  California  number  about  the  same 
as  on  the  high  plains  of  Arizona,  New  Mexico,  and  Colorado. 
There  are  usually  from  forty  to  sixty  cloudy  days  during  the  year, 
except  perhaps  in  particular  locations  on  or  near  the  coast,  where 
the  effect  from  fog  is  greatly  felt.  In  the  inland  desert-country  in 
Southeastern  California  and  Southwestern  Arizona  the  total  of  cloudy 
days  numbers  barely  twenty  during  the  year. 

The  average  annual  wind-movement  of  San  Diego  is  equal  to  a 
velocity  of  5.6  miles  per  hour;  at  Los  Angeles,  5.1  miles;  and  at 
Santa  Barbara  about  4  miles  per  hour.  The  general  movement  in 
California  is  usually  small.  "  The  feature  which  most  impresses  the 
observer  upon  the  Pacific  coast  in  his  study  of  the  winds  is  their 
regularity.  .  .  .  He  knows  that  at  certain  seasons  there  will 
be  a  prevalence  of  wind  from  a  certain  quarter,  and  that  at  a  certain 
time  of  each  day  the  wind  will  rise.  He  knows  that  a  persistence 
of  the  wind  from  a  certain  quarter  will  bring  a  very  moist  atmos- 
phere and  rain,  while  the  current  from  another  quarter  as  surely 
means  clear,  cool  weather,  with  a  moderately  humid  atmosphere  ; 
and  from  yet  another  quarter  means  an  exceedingly  dry  atmosphere, 
cold  in  winter,  hot  in  summer.  .  .  .  While  the  whole  Pacific 
coast  has  much  less  really  calm  weather  than  the  Atlantic  coast,  yet 
the  records  of  the  Signal  Service  show  that  the  total  wind-movement 
is  less;  in  other  words,  in  a  given  length  of  time  there  are  more 
hours  of  wind  but  of  less  velocity.  It  is  a  region  of  more  continuous 
wind-currents,  but  of  milder  character.  The  brisk  sea-breeze  is 
diurnal  ;  the  gale  rare ;  the  hurricane  and  the  cyclone  are  un- 
known."^ 

In  an  entertaining  discussion  of  the  climatic  characteristics  of 
Southern  California  by  Dr.  C.  P.  Kemondino,  of  San  Diego,  in  a 
magazine  article,"  he  refers  to  the  great  range  of  the  rainfall  over 
that  country  from  the  lowest  yearly  record  to  the  highest  twelve- 
hour  record  for  the  United  States,  as  indicating  a  "  land  of  seeming 
and  incomprehensible  climatic  contradictions."  The  arctic  current 
that  passes  the  coast  with  its  waters  never  below  60°  F.  in  winter, 
nor  over  66°  in  summer,  he  regards  as  the  ^' great  equalizer  of 
Southern  California  temperature." 

Before  summing  up  the  advantages  of  California  as  a  health- 
resort  a  frequent  source  of  error  in  estimating  the  character  of  the 

1  Dr.  J.  P.  Widney. 

-  California  as;a  Health-resort.    P.  0.  Remondino,  in  the  California  Magazine,  October,  1893. 


312  MEDICAL  CLIMATOLOGY. 

climate  should  be  particularly  pointed  out.  The  great  number  of 
days  of  sunshine  and  the  small  amount  of  annual  rainfall  should 
never  be  confused  with  the  actual  degree  of  atmospheric  humidity. 

In  connection  with  any  discussion  of  the  climate  of  California 
this  important  fact  should  always  be  kept  in  mind. 

When  writers  speak  of  its  "  dryness  "  they  mean — if  they  mean 
anything — to  refer  to  the  interior  desert-country,  beyond  the 
mountains,  where  the  wind  has  lost  its  coolness  and  moisture,  and 
where  it  is  dry,  but  for  most  of  the  year  excessively  hot  during 
the  day,  although  somewhat  cooler  at  night.  When  they  speak  of 
its  ''coolness"  they  refer  to  the  coast-districts,  where  high  tempera- 
tures are  rare  and  the  cool  sea-breeze  is  ftdl  of  moisture.  There 
are  found  the  features  of  an  ocean  climate,  and  this  is  the  secret  of 
its  equability. 

In  order  to  have  a  general  knowledge  of  the  climate  of  Southern 
California  this  relative  distinction  is  important :  the  coast  is  cool 
and  moist ;  the  interior  is  hot  and  dry. 

Or,  to  put  it  a  little  differently,  it  should  be  thoroughly  understood 
by  the  Eastern  visitor  in  search  of  health  that  if  he  seeks  more  days 
of  sunshine  and  opportunities  for  outdoor  life,  with  a  more  equable 
temperature  and  an  average  humidity  a  little  greater  than  that  of 
New  York  or  Boston,^  he  can  find  what  he  desires  at  Santa  Barbara 
or  Sau  Diego. 

If  he  needs  the  element  of  absolute  dryness  with  low  altitude  and 
sunshine,  he  will  hardly  find  them  together,  except  along  the  low 
plains  of  Arizona  and  New  Mexico  ;  that  is,  while  the  barren  inland 
desert-country  of  California  is  dry,  it  lacks  the  conveniences  of 
civilization,  w^hich  caunot  be  obtained  short  of  the  towns  of  Phoenix, 
Tucson,  or  El  Paso. 


1  The  accompanying  table,  taken  from  records  of  U.  S.  Weather  Bureau,  shows  that  the 
number  of  grains  of  moisture  to  each  cubic  foot  of  air  averages  during  the  year  more  by  one- 
third  along  the  coast  of  Southern  California  than  in  Boston  or  New  York.    This  is  partly  owing 
to  a  higher  average  of  temperature. 
From  Table  V.  : 

Mean  annual 

Tempera-  Relative  Absolute 

ture.  humidity.  humidity. 

New  York 52°  73  per  cent.  3.19  grains. 

Boston 49  72        "  2.84 

Santa  Barbara      ....    60  73        "  4.20        " 

Los  Angeles 62  72        "  4.42 

San  Diego 61  73        "  4.34 


PACIFIC  SLOPE  REGION.  313 

There  is,  however,  a  good  country  along  the  foot-hills  from  Sierra 
Madre  to  Beaumont,  where  on  the  ''  benches  "  of  from  1500  to  3000 
feet  elevation  the  air  is  moderately  dry.  The  winters  throughout 
this  region  are  mild,  but  except  at  a  considerable  elevation  the 
summers  away  from  the  sea  are  cloudless  and  quite  hot. 

It  may  be  well  to  call  attention  to  the  fact  that  the  climate  only 
is  under  consideration  here,  the  matter  of  accommodations  being 
referred  to  elsewhere. 

For  a  cool,  dry  air  there  are  the  elevated  plains  of  Arizona,  New 
Mexico,  and  Colorado. 

The  marked  changes  of  temperature  during  the  day  in  California 
are  frequently  trying,  and  the  humidity  is  sometimes  greatly  in- 
creased by  fogs  and  in  winter  by  protracted  rains.  It  is  a  point 
worth  noting  that  even  when  the  atmosphere  has  been  fairly  dry 
from  11  A.M.  to  5  p.m.,  it  is  always  damp  at  night.  The  author 
has  noticed  this  at  Redlands — one  of  the  most  favorably  situated  of 
the  inland  towns.  On  one  occasion  when  at  4.30  p.m.  the  relative 
humidity,  as  indicated  by  the  hygrometer,  was  55  per  cent.,  at  6 
p.m.  it  had  increased  to  80  per  cent,  and  a  light  haze  was  visible 
in  the  valley. 

While  the  minimum  relative  humidity  at  Redlands  is  sometimes 
as  low  as  30  per  cent,  for  a  limited  period  taken  during  the  middle 
of  the  day,  it  always  reads  high  during  the  night,  and  will  probably 
be  somewhere  from  70  to  80  per  cent,  or  over,  with  a  night- temper- 
ature ranging  usually  during  the  year  from  44°  to  60°  and  in  the 
winter  from  44°  to  52°  ;  freezing  weather  is  very  rare.  This  means 
to  an  invalid  a  climate  possessing  perhaps  six  hours  in  the  day  of 
moderate  dryness  and  eighteen  hours  of  positive  dampness. 

This  peculiarity  of  the  climate  of  Southern  California  explains 
many  of  its  apparent  contradictious.  The  great  difference  between 
the  character  of  the  atmosphere  during  the  day  and  during  the 
night  usually  escapes  observation.  It  is  of  importance  because  it 
shows  the  danger  of  making  an  estimate  of  the  climate  without 
considering  the  prepondering  night-influence. 

The  weather-records  are  not  so  complete  for  the  night  as  for  the 
day,  but  they  are  sufficiently  so  to  establish  this  fact — that,  in  spite 
of  the  great  amount  of  sunshine  during  the  day  in  California,  the 
foggy  and  damp  nights  and  mornings  take  up  a  great  part  of  the 
twenty-four  hours. 

At  Los  Angeles  observations  taken  at  8.15  and  8.07  p.m.  (local 


314 


MEDICAL  CLIMATOLOGY. 


time)  for  six  years  (January,  1882,  to  December,  1887)  show  the 

following  results  by  seasons  (for  office  of  United  States  Weather 

Bureau)  : 

Night-  Relative 

temperature.  humidity. 

AVinter 52°  76  per  cent. 

Spring 57  81         " 

Summer 65  82         " 

Autumn 60  82        " 

Tearly  mean 58  80        " 


Observations  showing  the  humidity  at  its  greatest,  between  mid- 
night and  4  a.m.,  have  never  been  published. 

One  more  example  of  night-humidity  in  California  may  be  quoted, 
taken  in  the  Ojai  Valley  during  ten  clear  nights  in  January  aud  Feb- 
ruary, 1895  :  Nordhoif,  average  hour  for  observations,  10  p.m.: 
mean  temperature,  47°;  mean  relative  humidity,  79  per  cent. 

The  observers  in  the  United  States  Weather  Bureau  stations  take 
synchronous  observations  at  8  p.m.,  Washington  or  75th  meridian 
time.  A  comparison  of  the  tables  of  relative  humidity  for  that  hour 
for  several  health-resort  stations,  on  the  elevated  inland  plains  and 
in  Southern  California,  may  be  of  value  in  this  connection. 

Mean  Monthly  Eelative  Humidity. 


Denver  (6  p.m.  local  time) 


J]  892 
•  1 1893 


Colorado  Springs  (6  p.m.  local  time)  1893 
No  complete  record  for  1892. 


Santa  Fe  (6  p.m.  local  time)     . 
El  Paso  (6  P.M.  local  time) 
San  Diego  (5  p.m.  local  time)  . 
Los  Angeles  (5  p.m.  local  time) 


fl892 
• '( 1893 

fl892 

•  ( 1893 

51892 
■  (  1893 

fl892 

•  1 1893 


Winter. 


Per  cent. 

55 
42 

41 

52 
36 


23 


Spring.     Summer.  Autumn. 


Per  cent.  Per  cent,  i  Per  cent. 


65 
66 


28 


61 
61 


31 
33 


70 
72 


63 
69 


Year. 


Per  cent. 
40 
37 


34 
29 


71 
70 


In  reading  the  preceding  summary  it  should  be  remembered  that 
the  observations  for  the  first  four  stations  were  taken  at  6  p.m., 
mountain  or  105th  meridian  time,  while  the  last  two  stations  hav^e 
the  advantage  of  having  had  the  observations  taken  still  earlier,  at 
5  P.M.,  Pacific  or  120th  meridian  time,  only  a  few  hours  after  the 
driest  portion  of  the  day. 


PACIFIC  SLOPE  BE  OWN.  315 

If  this  record  of  relative  humidity  for  Los  Angeles,  taken  at  5 
P.M.,  is  compared  with  the  record  of  the  same  station  taken  at  8 
P.M.,  which  wvas  given  on  page  313,  the  steady  increase  of  moisture 
with  the  approach  of  night  at  all  seasons  becomes  most  evident. 

On  the  elevated  plains  of  Colorado  or  Northern  New  Mexico  the 
night-air  can  be  admitted  into  sleeping-rooms  od  the  coldest  nights 
in  winter  because  it  is  so  dry.  The  temperature  of  a  room  with  the 
window  partly  open  seldom  falls  below  40°  F.,  even  if  the  air  out- 
side is  "10°.  At  that  temperature,  even  with  70  per  cent,  of  rela- 
tive humidity,  the  amount  of  absolute  humidity  the  air  can  hold  is 
less  than  one  grain  (0.91)  to  the  cubic  foot. 

In  California,  on  the  contrary,  as  in  the  Riviera,  the  night-air  is 
usually  damp  aud  frequently  saturated  with  fog. 

To  those  to  whom  the  presence  of  dry  air  is  not  important  Cali- 
fornia offers  many  attractions. 

From  Monterey  to  San  Diego  are  wooded  ranges,  fertile  valleys, 
vineyards,  orange  and  lemon  groves,  tropical  and  semitropical 
fruit  in  abundance,  plenty  of  sunshine,  well-built  and  prosperous 
towns,  pleasant  society,  and  for  the  transient  visitor,  what  is  most 
important,  good  hotel  and  boarding  accommodations. 

The  winter  or  rainy  season  is  the  favorite  time  for  visiting  Cali- 
fornia. The  monthly  rainfall  at  that  time  is  not  usually  more  than 
the  normal  monthly  rainfall  for  Eastern  cities,  and  there  are  longer 
periods  of  fine  weather.  The  welcome  rains  bring  a  vivid  green  to 
the  brown  valleys  and  hills,  and  the  beautiful  "procession  of  the 
flowers,"  which  continues  from  December  to  May,  enraptures  Eastern 
visitors. 

In  the  protection  from  cold  northern  or  eastern  winds  afforded 
by  the  mountains  (with  the  additional  climatic  advantage  of  the 
miles  of  desert  beyond),  its  soft,  balmy  air,  bright  days,  and  equa- 
bility of  temperature  from  one  season  to  another,  this  southern  coast 
resembles  the  Riviera  and  may  even  claim  superiority  over  that 
resort. 

Some  of  these  points  of  comparison  are  alluded  to  in  the  more 
detailed  descriptions  of  the  towns  themselves  (see  Santa  Barbara). 

The  attention  of  invalids  or  delicate  persons  should  be  directed  to 
a  marked  feature  of  the  Californian  climate — that  is,  its  peculiar  chil- 
liness in  the  shade  and  when  the  wind  blows,  even  on  a  summer- 
day.      It  is  always  chilly  at  nightfall,  at  which  time  a  light  over- 


316  MEDICAL  CLIMATOLOGY. 

coat  or  wrap  is  needed  all  the  year  round.  Rooms  with  a  sunny 
exposure  are  much  to  be  desired. 

It  is  greatly  to  be  regretted  that  no  suitable  health-resort  station 
has  been  developed  in  the  highlands  of  Southern  California,  where 
the  natural  advantages  of  sandy  soil,  soft  water,  moderate  elevation, 
and  an  atmosphere  containing  less  moisture  than  is  to  be  found 
directly  on  the  coast  could  be  supplemented  with  good  accommoda- 
tions. Such  a  resort  is  possible.  Beaumont  (2500  feet)  and  the 
higher  ^'benches"  above  maybe  suggested  as  possessing  some  of 
these  advantages.  The  Sospe  Valley,  above  Ventura,  which  is 
moderately  elevated  and  similar  in  character,  has  been  strongly 
recommended,  and  other  locations  can  be  found  equally  good  if 
not  superior. 

In  San  Diego  County,  thirty  or  forty  miles  from  the  sea,  are  sev- 
eral places  which  might  be  developed  into  health-resort  stations, 
such  as  Alpine  (2200  feet) ;  Ballena  (2500  feet) ;  the  Santa  Isabel 
Valley  (3200  feet);  Julian  (4300  feet);  Cuyamaca  (4700  feet)  ;  and 
the  Palomar  and  Coleman  valleys  (each  4000  feet).  Above  an  alti- 
tude of  2500  feet  the  trees  grow  more  thickly,  and  fir,  pine,  and 
oak  trees  are  found  up  to  the  crest  of  the  mountains.  On  the  west 
side  of  the  mountains  the  rainfall  also  increases. 

In  the  desert  east  of  Jacinto  are  stations  on  the  Southern  Pacific 
Eailroad  where  the  experiment  of  living  a  little  below  the  sea-level 
may  be  tried,  viz.,  at  Salton  (260  feet  depression)  and  Volcano 
Springs  (220  feet  depression) ;  good  accommodations  are  lacking. 
Indio  (50  feet  depression)  has  better  facilities  for  visitors,  but  is  not 
so  low. 

San  Diego.  Population,  18,000.  The  bay  of  San  Diego  is  a 
beautiful  land-locked  body  of  water  twelve  miles  long  by  a  mile 
wide.  It  is  the  best  natural  harbor  south  of  San  Francisco ;  but, 
although  the  settlement  dates  from  1542,  when  it  was  first  discov- 
ered by  Cabrillo,  its  commercial  supremacy  is  still  in  the  future. 

The  completion  of  the  Nicaragua  Canal  will  be  of  the  greatest 
benefit  to  this  port,  which,  from  the  strength  of  its  geographical 
position,  will  receive  a  large  share  of  the  enormous  trade  that  will 
then  be  developed. 

The  town  of  San  Diego  lies  on  the  main  land,  facing  the  Pacific. 
Dr.  Walter  Lindley  thus  describes  it :  '*  Situated  on  one  of  the  most 
perfect  harbors  in  the  world,  with  vessels  unloading  at  its  wharves 
from  all  the  chief  ports  of  civilization,  the  culmination  of  the  Santa 


PACIFIC  SLOPE  REGION.  317 

F6  Railway  system,  that  brings  it  into  intimate  relations  with  Chi- 
cago, New  York,  and  Boston  ;  planted  on  a  series  of  hills  that  gently 
slope  to  the  ocean,  with  a  soil  that  produces  almost  everything  de- 
sirable from  a  pumpkin  to  an  olive  ;  with  business  blocks  which, 
for  elegance,  solidity,  and  size,  are  rarely  surpassed  ;  with  a  climate 
that  is  enjoyable  and  healthful  both  summer  and  winter  ;  with  every 
facility  for  boating,  fishing,  and  hunting;  with  a  population  noted 
for  culture  and  refinement ;  with  schools,  churches,  and  hotels  that 
would  be  creditable  to  much  larger  cities  ;  with  commercial  prospects 
of  dazzling  brilliancy — with  all  these  attributes  the  visitor  does  not 
wonder  when  he  finds  that  every  one  of  San  Diego's  fifteen  thousand 
inhabitants,  from  the  infant  just  beginning  to  prattle  to  the  great- 
grandmother  who  dozes  away  the  sunny  Christmas-day  in  her  arm- 
chair on  the  veranda — has  learned  to  sing  her  praises  loud  and 
long."^ 

The  soil  in  the  highest  portions  of  the  town  is  sandy.  The  shores 
of  the  bay  are  high  at  Point  Loma — the  entrance — but  low  and 
marshy  around  the  southern  end.  The  mesa  or  tablelands  rise 
higher  going  from  the  bay  until  they  reach  the  mountains,  distant 
about  forty  miles.  In  the  fertile  valleys  and  on  the  hillsides  a  great 
variety  of  soil  can  be  found. 

San  Diego  is  now  supplied  with  pure,  soft  water,  brought  from 
the  mountains.     There  are  also  wells. 

The  natural  facilities  for  drainage  are  good.  Forty  miles  of 
sewers  emptying  into  the  bay  have  already  (1894)  been  built. 

San  Diego  has  several  lines  of  street-cars,  mostly  electric.  There 
are  a  number  of  good  hotels. 

One  of  the  best  portions  of  the  town  for  residence  is  Florence 
Heights,  which  lies  at  an  elevation  of  180  feet  above  the  sea. 

The  climate  of  San  Diego  is  noted  for  its  equability,  the  range  of 
the  mercury  between  winter  and  summer  being  usually  under  15°. 
The  monthly  mean  temperature  for  January  is  53°;  for  July,  68°; 
annual  mean,  61°. -  The  average  number  of  days  during  the  year 
above  90°,  1  ;  below  32°,  none.  During  twenty-three  years  the 
records  show  that  the  mercury  three  times  rose  to  100°  (going  once 
to  101°).  It  went  to  95°  but  three  times,  and  to  90°  but  seven- 
teen times.  It  does  not  usually  reach  86°  more  than  twice  a  year. 
The  highest  temperatures  are  likely  to  be  recorded  in  September. 

1  California  of  the  South.    Walter  Lindley,  M.D.,  18SS. 
■-  Government  record  for  twenty-three  years— to  1894. 


318  MEDICAL  CLIMATOLOGY. 

Summer-nights  are  invariably  cool.  Frost  is  said  to  be  unknown 
on  the  coast,  although  32°  has  been  recorded  five  times  in  twenty- 
ihree  years.  In  the  foot-hills  a  thin  skim  is  sometimes  formed 
on  the  lowest  lands  when  the  slopes  of  the  uplands  are  exempt. 
The  temperature  of  the  winter-days  on  the  high  mesa  near  the 
mountains  is  said  to  be  usually  about  45°  at  daylight,  running  to 
65°  or  70°  at  noon.  It  is  seldom  as  low  as  55°  at  noon,  and  some- 
times it  is  as  high  as  75°. 

San  Diego  has  an  annual  rainfall  of  10  inches.  During  a  "  dry  " 
winter  it  has  been  known  to  be  as  low  as  4  inches.  The  heaviest 
rainfall  was  during  the  season  of  1883-'84,  when  25.97  inches  fell. 
There  are  few  stormy  days  during  the  year  (37),  but  a  large  number 
of  cloudy  days  for  Southern  California  (69),  and  the  degree  of 
humidity  is  high. 

Fogs  are  less  prevalent  at  San  Diego  than  at  Los  Angeles.^  Four 
or  five  miles  inland  from  San  Diego  the  amount  of  fog  is  still  less 
than  directly  on  the  bay. 

The  wind-movement  is  moderate,  the  yearly  average  being  5.6 
miles  per  hour. 

The  prevailing  sea-wind  is  frequently  alluded  to  by  local  writers 
as  "dry".  This  is  an  error,  as  will  appear  if  the  movement  of  the 
winds  is  considered.  The  wind  is  dry  when  it  first  starts  from  the 
heated  deserts  of  Southeastern  California  and  Southwestern  Arizona, 
and  rising  to  a  great  elevation  passes  out  to  sea  over  the  incoming  cur- 
rents ;  but  when  it  has  to  descend  to  the  ocean  about  latitude  30° 
and,  reversiug  its  course,  becomes  in  turn  the  southwest  or  west 
wind  blowing  landward,  it  presents  such  conditions  for  the  absorption 
of  moisture  that  long  before  it  reaches  the  coast  of  California  its 
original  dryness  has  been  completely  lost.  This  is  the  daily  wind 
from  the  sea. 

What  its  characteristics  are,  then,  is  shown  by  the  meteorological 
analysis,  which  can  be  better  illustrated  by  instituting  a  comparison 
with  a  locality  of  admitted  dryness. 

El  Paso  will  afford  an  excellent  parallel,-  although  it  has  a  little 
higher  temperature  during  the  year — a  fact  slightly  to  the  advan- 
tage of  San  Diego,  as  the  warmer  the  air  is  the  greater  the  amount 
of  moisture  it  can  contain. 

1  See  reference  to  night  and  morning  fogs,  in  article  on  the  Climate  of  California. 
-  Latitude  of  San  Diego,  32°  43'  N.    Latitude  of  El  Paso,  30°  47'  N. 


PACIFIC  SLOPE  REGION.  319 

Tempera-  Relative  Absolute  Dew- 

ture.  humidity.  humidity.  point. 

San  Diego     .         .     61°  73  per  ct.  4.34  grains.        52° 

El  Paso         .         .     64  48       "  3.16       "  40 

We  thus  find  that  Sail  Diego,  at  nearly  the  same  temperature, 
exhibits  over  EI  Paso  58  per  cent,  increase  in  relative  humidity, 
37  per  cent,  increase  in  absolute  humidity,  and  30  per  ceut.  increase 
in  the  dew-point.  The  only  conclusion  possible  to  reach  is  that  air 
which  at  61°  of  temperature  shows  an  annual  mean  of  73  per  cent, 
of  relative  humidity,  4.34  grains  of  absolute  humidity  to  the  cubic 
foot,  and  52°  for  the  dew-point  (or  point  of  saturation),  cannot  be 
properly  described  except  as  a  warm,  moist  climate. 

Particular  emphasis  is  given  to  this  point,  because  so  many  pul- 
monary invalids — to  whom  the  amount  of  moisture  in  the  air  is 
sometimes  of  the  greatest  importance — have  suffered  sadly  from  lack 
of  early  knowledge  regarding  this  detail. 

It  is  surprising  to  notice  how  constantly  one  meets  references  to 
the  ^'dryness"  of  this  coast,  not  only  in  guide-books  and  in  edito- 
rial utterances,  but  even  in  articles  on  the  climate  by  medical 
writers.  On  the  part  of  strangers  such  a  misconception  would  prob- 
ably be  due  to  mistaken  inferences  based  on  the  large  number  of 
sunny  days  during  the  year  and  on  the  small  amount  of  the  annual 
rainfall.  It  is  unfortunate  that  it  should  be  kept  up  by  local  writers 
to  whom  the  actual  dampness  of  the  country  within  the  ocean-influ- 
ence ought  to  be  well  known. '^ 

Admitting,  then,  as  we  must,  the  presence  of  the  important  factor 
of  humidity  in  this  as  in  all  coast  climates,  it  can  be  said  that  the 
climate  is  delightful,  equable,  and  healthful.  The  ocean-current 
that  brings  so  much  fog  and  chill  to  the  coast  north  of  Monterey 
passes  by  so  far  out  to  sea  that  its  influence  is  greatly  modified. 
Curiously  enough,  it  is  said  that  one  hundred  and  fifty  miles  fur- 
ther south  in  Lower  California,  where  it  again  approaches  the  shore, 
it  brings  to  San  Quintin  a  climate  cooler  than  that  of  San  Diego. 

Opposite  San  Diego,  on  the  ocean-side  of  the  promontory   that 

1  An  article  by  Mr.  John  D  Parker  on  "California  Electrical  Storms,"  in  the  American  Meteoro- 
logical Journal  for  June,  1895,  suggests  that  "  one  cause  for  the  iufrequency  of  electrical  storms 
is  probably  found  in  the  humidity  of  the  atmosphere.  .  .  .  The  humidity  of  the  atmos- 
phere in  California,  so  contiguous  to  the  Pacific  Ocean,  is  naturally  much  greater  than  that 
found  at  points  more  remote  from  large  bodies  of  water.  At  San  Diego  the  mean  humidity  of 
the  air  in  1891  was  74  per  cent,  of  complete  saturation ;  in  1892,  76  per  cent.  ;  in  1893,  74  per 
cent. ;  and  the  mean  humidity  for  eleven  years,  from  1884  to  1894  inclusive,  is  77  per  cent." 
This  percentage  of  humidity  for  San  Diego,  which  is  for  different  years  than  those  used  for 
the  computations  for  this  book,  is  even  more  excessive. 


320  MEDICAL  CLIMATOLOGY. 

forms  the  harbor,  is  Coronado  Beach,  the  whole  development  of 
^hich — from  the  great  hotel  of  750  rooms  to  the  tropical  garden — 
has  taken  place  since  1887.  It  is  an  attractive  resort  with  an 
equable  marine  climate,  and  in  many  respects  is  unequalled  in  the 
country/ 

Coronado  Beach  is  easily  reached  by  ferry  from  San  Diego. 
There  are  a  great  many  cottages  near  the  hotel,  and  quite  a  settle- 
ment is  growing  up,  with  shade-  and  fruit-trees,  which  are  developing 
rapidly  under  the  stimulus  of  irrigation. 

The  Coronado  Springs  are  worthy  of  notice.  They  are  thirty 
feet  above  tide-water  and  flow  50,000  gallons  per  hour.  The 
water  is  pure,  soft,  and  sparkling,  resembling  the  well-known  Wauk- 
esha Springs  in  Wisconsin.  There  are  about  26  grains  of  total 
solids  to  the  gallon.^  It  is  carbonated  and  bottled  for  commercial 
uses,  making  a  fine  table-water. 

Miss  Kate  Field,  in  a  letter  which  appeared  in  the  San  Francisco 
Chronicle,  in  June,  1893,  made  a  strong  and  characteristic  plea  for 
better  water  for  domestic  purposes  in  California.  Her  summary  of 
the  general  quality  of  the  water  in  the  State  is  somewhat  severe, 
as  many  towns  are  supplied  with  excellent  water  from  either  the 
mountains  or  from  artesian  wells ;  but  what  she  says  is  well  worth 
reading,  especially  for  its  bearing  on  the  climate. 

^'California  has  herself  to  thank  for  her  national  reputation  as 
the  purveyor  of  bad  svater.  Nature  produces  no  baue  without  an 
antidote.  Though  mountain  and  desert  send  water  freighted  with 
lime  or  alkali,  heaven  sends  rain  pure,  soft,  and  health-giving. 
If  every  house  in  Southern  and  Lower  California  should  have  its 
cistern,  nobody  need  drink  hard  or  poisonous  water.  Were  it 
known  to  tourists  that  soft  water  abounded  in  hotels  and  boarding- 
houses  many  an  invalid  would  hasten  to  breathe  the  balmiest  air  in 
this  country. 

"  Rain,  however,  is  not  the  only  means  by  which  soft  water  can 

1  For  meteorological  data,  see  records  for  San  Diego,  Tables  V.-IX. 

2  Coronado  Springs.    Light  alkalo-carbonated  water.    Analysis  by  C.  Gilbert  Wheeler,  of 
Chicago. 

Grains  in  U.  S.  gallon.  Grains  in  U.  S.  gallon. 

.    10.16  Ferrous  sesquioxide    .        .        .      0.0-t 

.      0.91  Silica 1.08 

0.55              Organic  matter  ....      0.99 
.      4.72  


Sodium  chloride 
Potassium  chloride 
Potassium  sulphate 
Magnesium  . 
Calcium  carbonate 
Calcium  sulphate 


6.48  Total  solids    .        .        .    26.25- 

1.32 


PACIFIC  SLOPE  REGION.  321 

be  obtained.  It  is  a  remarkable,  but  little  recoguized  fact  tiiat  the 
dew  or  fog  of  the  Pacific  coast  would,  if  caught  in  cisterns,  supply 
every  family  with  soft  water.  Seeing  is  believing,  and  I  have  seen. 
An  acquaintance  of  mine,  liviug  near  San  Diego,  has  never  dug  a 
well,  though  his  house  is  half  a  mile  from  the  sea.  His  cistern  sup- 
plies all  the  water  necessary  for  domestic  purposes  and  for  a  horse 
and  cow.  Twenty-four  hundred  square  feet  of  roofs  produce  140 
gallons  of  water  in  twenty-four  hours.  Multiply  140  by  365  and 
you  are  amazed  to  learn  that  this  householder  obtains  an  annual 
supply  of  51,100  gallons  of  soft  water  without  counting  the  rain- 
fall. Another  acquaintance,  wliile  building  on  Coronado  Beach  a 
cottage  with  a  roof  measuring  1000  square  feet,  saw  a  stream  of 
water  as  large  as  a  small  pen-handle  running  from  this  roof  as  late 
as  9  o'clock  in  the  morning.  Here  is  a  beneficent  nature  coming 
to  the  rescue  of  that  beautiful  coast,  yet  purblind  residents  rarely 
accept  the  blessing  falling  upon  them  nightly. 

''  '  Irrigation  ?  No,  indeed,'  said  a  rauchero,  as  we  sat  in  the 
shadow  of  his  cottage  on  the  border  of  Mexico.  '  We  don't  need 
irrigation  for  farming,  as  the  rainfall  suffices  to  raise  crops  in  our 
region.  If  it  did  nut,  dew  would  supply  the  deficiency.  Here  we 
are  twelve  miles  from  the  sen,  yet  the  nightly  moisture  almost  equals 
rain.  We  don't  irrigate,  but,  as  we  have  no  well,  we  send  sixty 
miles  for  drinking-water.' 

''  '  Why  don't  you  utilize  your  wonderful  fog  ?'  I  asked.  *  Why 
don't  you  put  gutters  and  spouts  on  your  roofs  and  improvise  a 
cistern  ?' 

''  '  By  Jove  !     I  never  thought  of  that.      That's  an  idea.' 

''Acting  on  this  suggestion  all  the  water  needed  for  domestic  pur- 
poses was  readily  obtained. 

"  Many  a  morning  I've  risen  at  Ensenada,  Lower  California, 
fully  persuaded  from  the  dripping  on  the  roof  that  rain  had  come, 
and  I've  found  a  fog  almost  thick  enough  to  cut  with  a  knife. 
Yet  not  one  drop  of  soft  water  could  be  had  at  the  hotel  for  love 
or  money.  Santa  Barbara  abounds  in  fogs  so  heavy  as  frequently 
to  lay  the  dust  in  summer',  despite  which  the  fastidious  traveller 
must  pay  ten  cents  a  quart  for  distilled  water  if  he  objects  to  coating 
his  raucous  membrane  with  lime. 

''South  America  has  learned  the  wealth  of  its  dews.  In  his 
memoirs  General  Sherman  refers  to  a  very  interesting  conversation 
in  which  Henry  A.  Wise,  then  our  Minister  to  Brazil,  '  enlarged 

21 


322  MEDICAL  CLIMATOLOGY. 

on  the  fact  that  Rio  was  supplied  from  the  "dews  of  heaven,"  for  it 
rarely  rains  there,  and  the  water  comes  from  the  mists  and  fogs 
which  hang  around  the  Corcovado,  drips  from  the  leaves  of  the 
trees,  and  is  conducted  to  the  madre  fountain  by  miles  of  tiled 
gutters. ' 

"  What  can  be  done  in  Rio  Janeiro  can  be  done  from  one  end  of 
California's  coast  to  the  other;  the  peninsula  itself  can  be  redeemed 
from  desolation.  Yet  though  nature  failed  to  furnish  this  welcome 
moisture,  there  are  simple  methods  of  distilling  water  that  come 
within  the  ken  of  all. 

"  '  For  heaven's  sake  don't  refer  to  our  fogs,'  exclaimed  a  boomer. 

'''Why  not?  They  are  a  boon  to  the  coast.  Moreover,  was 
there  ever  seaboard  without  fog  ?' 

"  'True;  but  if  people  knew  we  had  fogs  they'd  be  frightened 
away.' 

"' What  kind  of  people  ?' 

"  'Invalids.' 

"  So  I'm  not  to  make  known  a  valuable  fact  because  it  may  keep 
a  few  sick  people  away  from  the  coast.  That's  the  reason  it  should 
be  advertised  far  and  wide  California  gains  nothing  by  concealing 
the  truth.  It  is  big  enough  and  wonderful  enough  and  varied  enough 
in  climate  to  be  honest  about  every  locality." 

Julian  (elevation,  4300  feet).  East  of  San  Diego  is  a  chain  of 
mountains  rising  higher  in  successive  ranges  until,  about  forty  miles 
from  the  coast,  they  culminate  in  pine-clad  summits  with  an  alti- 
tude of  from  4000  to  6000  feet. 

The  rainfall  on  the  western  slope  of  these  mountains  is  said  to 
amount  to  about  20  inches  per  annum  at  3000  feet  altitude  and  30 
to  34  inches  on  the  top  of  the  range.  It  is  probal)ly  somewhat 
more,  as  General  A.  W.  Greely,  in.  his  Report  on  the  Climatology  of 
the  Arid  Regions  of  the  United  States,  1891,  credits  Julian  with  about 
the  same  annual  precipitation  as  Pittsburg,  and  by  means  of  an  inter- 
esting comparison  shows  the  difference  in  the  methods  of  distribution. 

The  following  is  by  seasons  : 


Winter. 

Spring. 

Summer. 

Autumn. 

Year.    Length  of  record. 

Julian, 

18.34  in. 

16.56  in. 

0.00  in. 

2.78  in. 

37.68  in.     6  years. 

Pittsburg, 

8.58  " 

8.53  " 

12.00  " 

7.60  " 

36.71        19      " 

The  California  rainy  season  is   made  still  moi'e  prominent  when 
the  year  is  divided  into  two  periods,  the  rainfall  at  Julian  being  for 


PACIFIC  SLOPE  REGION.  323 

November  to  April  30.40  inches;  for  May  to  Oetober,  1.28  inch. 
General  Greely  remarks:  ^'  At  Julian  only  9  per  cent,  falls  from  the 
1st  of  May  to  the  last  of  November,  while  nearly  one-half  (48  per 
cent.)  of  the  entire  precipitation  of  the  year  falls  during  the  months 
of  February  and  March."  The  greatest  seasonal  rainfall  was  in  1883 
and  1884,  w4ien  it  amounted  to  61.62  inches.  The  smallest  record 
is  25.89  inches. 

'^  The  soil  on  the  hillsides  is  more  or  less  gravelly,  resulting  from 
the  decomposition  of  granitic  rock.  Tn  the  valleys  it  is  finer  and 
often  of  a  brownish  or  reddish  color,  and  strong  and  fertile.  In 
the  lowest  part  of  the  valleys  it  is  a  dark  alluvium." 

Below  4000  feet  the  timber  is  largely  live-oak;  above  that  eleva- 
tion there  are  pine,  fir,  cedar,  and  deciduous  oak  groves.  Fruits 
and  cereals  can  be  successfully  grown  on  the  western  slope  of  the 
mountains,  where  springs  and  small  streams  are  abundant.  There 
are  fruit-ranches  near  Julian,  which  is  also  the  centre  of  mining- 
interests. 

The  eastern  slope  pitches  more  steeply  down  to  the  desert,  which 
lies  nearly  at  the  level  of  the  sea.  On  this  slope  little  rain  falls, 
and  the  increased  dryness  and  temperature  produce  a  very  different 
climate. 

There  is  no  meteorological  record  for  the  eastern  side  of  these 
mountains  at  4000  or  5000  feet  elevation,  but  the  iuflueuce  of  the 
ocean  must  have  almost  vanished,  while  the  influence  of  the  desert 
is  marked. 

The  description  of  the  climate  of  Hesperia  and  Daggett,  oh  the 
Mojave  Desert  (pages  333  and  334),  may  be  of  value  in  this  con- 
nection. 

If  water  could  be  impounded  and  brought  from  the  summits,  or 
around  from  the  western  slope,  this  arid  land  would  undoubtedly 
produce  luxuriantly  and  trees  and  verdure  would  reward  the  culti- 
vator. 

The  winter  climate  is  probably  fine.  The  degree  of  heat  of  blasts 
from  the  desert  in  summer  at  that  altitude  is  not  yet  a  matter  of 
record. 

The  hill  country  back  of  San  Diego  has  been  proved  by  indi- 
vidual experience  to  possess  most  valuable  climatic  characteristics,  and 
it  is  to  be  hoped  that  the  necessary  detailed  information  will  soon  be 
obtainable.' 

1  See  Climate  of  Calilornia. 


324  MEDICAL  CLIMATOLOGY. 

Los  Ang-eles  (elevation,  330  feet ;  populatiou,  80,000).  The 
full  name  bestowed  hy  its  pious  founders  was  La  Puebla  de  Nuestra 
Senora  la  Reina  de  Los  Angeles — The  Town  of  Our  Lady  the  Queen 
of  the  Angels — eight-tenths  of  which  we  leave  off  nowadays,  and 
usually  mispronounce  the  remainder.  The  town  is  on  a  rolling 
plain,  fourteen  miles  from  the  sea  and  about  the  same  distance  from 
the  mountains.  It  is  a  beautiful  and  interesting  place,  full  of  archi- 
tectural and  social  coutiasts.  Several  elements  go  to  make  up  the 
city,  the  Southern  *or  Spanish,  and  the  American  ;  and  brown 
faces,  betraying  Castilian  and  Indian  ancestry,  mingle  on  the  busy 
streets  with  those  of  the  fairer-skinned  Yankee  type.  Low  adobe- 
quarters  and  American  country  houses  are  found  near  each  other, 
within  a  few  minutes'  walk,  although  the  old-fashioned  "adobe"  is 
growing  more  rare.  Modern  office-buildings  appear  within  sound 
of  the  bells  of  the  early  Missions. 

The  near  presence  of  the  mountains  insures  a  good  supply  of  water 
both  for  domestic  and  irrigating  uses.  Much  of  the  sewage  has 
been  used  for  the  purpose  of  fertilizing  the  plains  below  the  city. 
Large  sewers  have  also  been  constructed  to  the  sea. 

Los  Angeles  is  well  supplied  with  hotels  and  churches.  The 
hotels  are,  however,  not  worthy  of  this  attractive  city.  Cable  and 
electric  cars  reach  all  points. 

South  of  latitude  35°,  that  portion  of  the  State  called  Southern 
California,  is  more  free  from  cold  summer-fogs  and  strong  winds 
than  the  country  near  San  Francisco.  Los  Angeles  is  far  enough 
from  the  sea  to  have  a  temperature  perceptibly  higher  in  summer 
and  lower  in  winter  than  directly  on  the  coast.  While  its  average 
annual  rainfall  is  but  18  inches,  it  is  subject  to  great  extremes.  For 
instance,  during  the  summers  of  1882  and  1883  there  were  12.67 
inches  of  rain.  During  the  seasons  of  1883  and  1884  there  were 
32.16  inches.  In  1892  and  1893  about  30  inches  fell.  The  mean 
annual  relative  humidity  is  72  per  cent. 

There  are  frequent  fogs  both  night  and  morning  during  the  spring 
and  summer.  They  usually  clear  up  during  the  forenoon.^  The 
average  number  of  foggy  nights  and  mornings  for  the  year  at  Los 
Angeles  is  57  days." 

The  percentage  of  cloudiness  and  sunshine  and  the  number  of 
clear  days  for  Los  Angeles  and  San  Diego  by  seasons  and  by  the 
year  are  as  follows  : 

1  See  Climate  of  California. 

-  From  records  of  thirteen  years  at  Los  Angeles  office  of  U.  S.  Weather  Bureau. 


PACIFIC  SLOPE  REGION. 


325 


Winter. 

Sj)ring. 

Summer. 

Autumn. 

Year 

Cloudiness  and 

o 

i 

d 

c 

12,  M 

d 

d 

JZ  JO 

H 

Length 
ot 

sunshine. 

C.2  aS 

Sfn^ 

C  " 

c.~ 

U~ 

=  .S     &Ct3 

^r^ 

a.5  c.S 

^A 

record. ^ 

Mea 
Cloud 

Mea 
sunsh 

2^ 

as^ 

1*    CO 

'C  '~ 

f.-o 

Mea 
Cloud 

Mea 
sunsh 

£^ 

I-  u 

>  0) 

S  b 

So 
o 

s|,gg 

0)  oi 

^■3 

S  o  S  5 

6:  g 

^•3 

p.c.  p.c. 

P.O. 

p.c. 

p.c.i 

p.c.jp.c. 

p.c.  p.c. 

Los  Angeles, 

34     66     49 

44 

56 

36 

31 

69      39 

25  j  75 

54 

33     67 

178 

11  years. 

San  Diego, 

39     61  '  37 

49 

51 

26 

46  '  54  j  24 

37  '  63 

38 

43  1  57 

125 

17    " 

Total  cloudiness    100  per  cent. 

The  highest  recorded  temperature  is  108°;  loM'est,  28°.  The  mean 
monthly  temperature  for  January  is  53°;  for  July,  72°;  for  the 
year,  62°. 

Average  annual  number  of  days  above  90°,  20 ;  below  32°,  none 
(one  day  in  1893).  Cloudy  days,  45 ;  stormy,  36  (means  for  six 
years). 

Normal  wind- movement  for  the  year,  5.1  miles  per  hour. 

Pasadena,  a  .suburb  of  Los  Angeles,  distant  nine  miles,  has  an 
elevation  of  900  feet.  It  is  twenty  miles  from  the  .sea  and  five  from 
the  mountains.  Population  about  9000.  Ample  supply  of  water. 
Soil  is  gray  gravel  mixed  with  brown  loam  ;  it  is  light  and  porous. 
Some  of  the  streets  are  paved. 

Pasadena  is  a  charming  little  city  of  attractive  homes.  As  a  place 
of  residence  its  social  advantages  are  well  known. 

There  have  not  been  any  records  published  of  moisture,  but  the 
percentage  of  relative  humidity  is  believed  to  be  about  60  for  the 
year.  Pasadena  is  usually  a  few  degrees  hotter  at  all  seasons  than 
Los  Angeles. 

There  are  large,  well-equipped  hotels  and  good  accommodations 
for  visitors. 

Sierra  Madre  is  a  settlement  twelve  miles  northeast  of  Los  An- 
geles, .situated  at  the  base  of  the  foot-hills,  1700  feet  above  the  sea. 
There  is  less  frost  at  this  elevation  than  in  the  lower  valleys,  and 
also  less  fog.  The  climate  is  considered  particularly  healthful,  and 
was  selected  by  the  State  Board  of  Health  in  1880  as  the  most  de- 
sirable for  consumptives  in  Southern  California. 

Along  the  foot  of  the  mountains  are  innumerable  desirable  loca- 
tions for  country  homes  and  fruit-farms,  where  an  invalid  can  avail 
him.self  of  the  best  there  is  in  California  outdoor  life. 


326  MEDICAL  CLIMATOLOGY. 

Echo  Mountain  (elevation,  3500  feet).  Four  miles  from  Pasa- 
dena is  Riibio  Pavilion,  at  an  elevation  of  2200  feet,  from  which  the 
cable-road  ascends  1300  feet  further  to  the  top  of  Echo  Mountain. 

The  Echo  Mountain  House  is  a  new  hotel  of  seventy  rooms,  com- 
manding wide  views  over  the  San  Gabriel  and  Los  Angeles  valleys 
and  the  Pacific  Ocean  beyond. 

It  is  claimed  that  the  climate  on  the  summit  "  is  equable  and  de- 
lightful during  the  entire  year.  When  clouds  and  fog  obstruct  the 
vision  and  render  residence  somewhat  uncomfortable  in  the  valley, 
the  mountain  is  invariably  bathed  in  sunshine."  One  of  the  sights 
from  the  hotel  is  to  see  the  fog  or  clouds  resting  over  the  valley  below. 

There  is  no  record  of  the  weather  on  the  summit  to  compare  with 
that  of  the  upper  valley,  but  it  is  said  to  be  warmer  in  winter  and 
cooler  in  summer  than  on  the  plain.  There  is  always  a  breeze  on 
the  veranda  of  the  hotel. 

Mount  Lowe  (elevation,  6000  feet).  The  summit  of  Mount 
Lowe,  still  higher  up,  is  to  be  provided  with  a  stone  hotel.  A  large 
observatory  has  been  built.  The  views  are  very  extensive.  Bridle- 
paths have  been  laid  out  through  the  mountain-paths  and  cailous. 

Wilson's  Peak  (5500  feet)  is  four  miles  east  of  Echo  Mountain. 
The  view  is  extensive  and  beautiful.  There  are  a  hotel  and  camp  on 
the  mountain.  Mount  Harvard  (5000  feet),  an  adjoining  peak,  is 
easily  reached  from  Pasadena  and  has  also  a  camp  for  the  accommo- 
dation of  visitors. 

Riverside  (elevation,  850  feet ;  population,  10,000)  is  situated 
ten  miles  south  of  San  Bernardino  and  sixty  miles  east  of  Los 
Angeles.  It  is  famous  for  its  orange-groves.  The  roads  are 
hard  and  well  shaded,  but  sometimes  dusty.  There  are  a  number 
of  handsome  residences.  The  town  is  supplied  with  good  hotels. 
Water  for  domestic  use  is  furnished  by  a  pipe-line  from  twenty- 
three  wells  (300  to  600  feet  in  depth),  located  nine  miles  above  the 
city  in  an  artesian  belt,  and  the  Waring  system  of  drainage  is  being 
introduced. 

A  local  physician,  writing  of  the  climate,  leniently  says  it  is 
"  warm,  but  not  hot,  reaching  in  the  summer  months  a  maximum 
of  108°  to  110°  and  in  the  winter  from  78°  to  80°.  ...  In 
addition  to  the  precipitation  in  rain,  occasional  and  very  infrequent 
fogs  add  a  trifle  to  the  total  moisture.  They  drift  into  the  valley 
from  the  seaward,  coming  up  in  the  early  morning  and  vanishing 
by  9  or  10  o'clock  in  the  forenoon.     They  occur  more  often  in  the 


PACIFIC  SLOPE  REGION.  327 

fall  and  winter  months,  but  come  so  seldom  and  are  so  light  that 
their  effect  upon  atraospberic  moisture  is  insignificant.  From  July, 
1885,  to  July,  1886,  there  were  280  absolutely  clear  days,  38  days 
of  rain,  in  many  of  which  there  was  simply  a  shower  with  a  pre- 
cipitation of  oae-tenth  of  an  inch  or  less,  the  balance  of  the  time 
being  clear,  and  47  days  in  which  there  was  a  longer  or  shorter 
interval  of  trifling  fog  in  the  early  morning."^ 

At  Riverside  these  fogs  are  less  felt  than  nearer  the  coast  or  moun- 
tains. 

Irrigation  is  extensively  used  on  the  groves  and  orchards.  The 
Santa  Ana  River — a  small  stream — flows  by  the  town.  A  curious 
fact  regarding  increase  of  rainfall  is  shown  by  compariug  the  pre- 
cipitation of  ten  years  ago  with  that  of  recent  years.  During  the 
four  years  from  1880  to  1883,  iuclusive,  the  annual  average  pre- 
cipitation was  4.42  inches ;  while  during  the  four  years  1890  to 
1893  it  was  10.69  inches,  an  increase  of  140  per  cent. 

The  average  yearly  rainfall  for  the  past  fourteen  years  was  10 
inches.  The  rainiest  months  are  usually  February  and  March. 
The  percentage  of  relative  humidity  during  the  year  1888  was: 
spring,  67  ;  summer,  56;  autumn,  63;  winter,  76.  From  De- 
cember, 1890,  to  September,  1891,  inclusive,  the  average  monthly 
relative  humidity  was  67  per  cent. 

The  mean  monthly  temperature  for  the  seasons  from  a  record  for 
twelve  years  is  :  spring,  60°;  summer,  74°;  autumn,  64°;  winter, 
51°.  The  mean  for  July  is  76°;  maximum,  106°;  mean  for  Au- 
gust, 76°;  maximum  104°;  mean  for  January,  50°;  minimum,  29°. 
The  average  for  the  year  is  62°.- 

Redlands  (elevation,  1350  feet  ;  population,  3500).  From  the 
end  of  the  platform  of  the  railroad  station  at  San  Bernardino,  facing 
to  the  east,  one  sees,  away  to  the  left,  the  high  range  of  the  San 
Bernardino  Mountains,  terminating  in  its  two  great  peaks  of  Gray- 
back  and  San  Bernardino,  each  rising  12,000  feet  above  the  level  of 
the  sea.  Twenty  miles  straight  ahead,  due  east,  the  huge  shoulders 
of  San  Jacinto  lift  their  snow-clad  crest  11,000  feet  into  the  air, 
while  filling  the  middle  ground  of  the  picture,  eight  miles  away,  the 
homes  and  orange-groves  of  Redlands  dot  the  hillsides  at  varying 
elevations  of  1300  to  1500  feet. 

The  delightfully  situated  town  of  Redlands  is  four  or  five  hundred 

1  A  Study  of  Riverside  Climate.    W.  B.  Sawyer,  M.D, 

2  Meteorological  record  from  pamphlet  issued  by  the  Riverside  Board  of  Trade,  1894. 


328  BIEDICAL  CLIMATOLOGY. 

feet  higher  tlian  its  neighbor,  San  Bernardino,  and  about  six  hun- 
dred feet  higher  than  Riverside,  which  is  distant  fifteen  miles  to  the 
southeast.      It  is  over  fifty  miles  from  the  Pacific  Ocean. 

The  settlements  of  Lugonia  and  ]\Ieutone  are  included  in  this 
description  of  Redlands. 

The  hotels  are  uot  large,  but  are  well  kept  and  furnish  good 
accommodations.  The  water-supply  of  Redlands  is  unsurpassed, 
coming  as  it  does  from  the  great  Bear  Valley  reservoir — eight 
miles  distant — which  is  situated  in  the  mountains  at  an  altitude  of 
6500  feet.  The  records  of  the  water  corporation  are  said  to  show 
an  annual  rainfall  of  40  inches  on  the  high  peaks,  which  illustrates 
how  the  mountains  "  milk  "  the  moist  sea-winds.  The  irrigating- 
pipes  throughout  the  valley  are  of  steel  and  are  buried  underground, 
a  method  considered  less  subject  to  evaporation  and  generally  supe- 
rior to  carrying  the  water  in  open  ditches.^ 

The  soil  of  the  hillsides  is  red  adobe,  most  fertile,  and,  of  course, 
muddy  after  a  rain.  In  the  low^est  portions  of  the  valley  it  is  a 
sandy  "  wash". 

The  annual  rainfall  at  Redlands  is  slightly  less  than  at  Los  An- 
geles. It  averages  15.32  inches,  divided  as  follows:  winter,  6.55; 
spring,  7.45;  summer,  0.48  ;  autumu,  0.94  inch. 

The  sea-l>reeze  blows  usually  from  10  o'clock  to  sunset,  increasing 
in  force  during  the  middle  of  the  afternoon.  The  presence  of  the 
high  range  on  the  north  protects  the  valley  from  desert-winds,  ex- 
cept for  an  occasional  norther  that  sweeps  around  by  way  of  the 
Cajon  Pass. 

There  is  frequently  an  early  morning-fog,  but  it  rarely  remains  after 
9  o'clock.     It  clears  here  an  hour  or  two  earlier  than  at  Los  Angeles. 

Like  all  of  the  California  towns  within  the  influence  of  the  coast 
climate,  Redlands  cannot  claim  extreme  or  long-continued  dryness. 
It  is,  however,  one  of  the  most  favorable  locations  in  Southern  Cali- 
fornia for  invalids  where  comfortable  quarters  can  be  secured.  Dur- 
ing the  summer  the  temperature  rises  pretty  high,  but  the  town  is 
conveniently  near  to  the  cool,  tree-covered  slopes  of  the  mountains. 

There  are  no  official  or  complete  records  of  the  humidity,  the  only 

1  Regarding  the  possible  influence  of  the  use  of  irrigation  in  Redlands,  it  should  be  noted 
that  irrigation  is  not  used  during  the  winter  and  early  spring  when  the  annual  rains  usually 
occur,  and  during  the  irrigating  season  each  grove  is  irrigated  for  three  days  at  a  time  but 
once  in  four  or  sis  weeks — not  continuously.  The  readings  of  the  hygrometer,  as  taken  by 
Mr.  E  X.  Peirce,  showed  that  Redlands  had  a  drier  air,  during  the  day  than  the  valleys  nearer 
the  sea-coast. 


PACIFIC  SLOPE  REGION.  329 

figures  being  furnished  by  voluntary  observers.  It  is  probably  safe 
to  say  that  the  general  average  of  the  relative  humidity  will  be  at 
least  5  per  cent,  less  than  at  Los  Angeles.  A  record  of  the  relative 
humidity  taken  at  Terracina  Heights  for  two  weeks  in  April,  1893, 
showed  at  8  a.m.  70  per  cent.;  at  12  M.  66  per  cent.;  at  6  p.m.  67 
per  cent.  During  the  night  the  amount  of  atmospheric  moisture 
was  greatly  increased.^ 

A  record  of  the  temperature  taken  by  a  voluntary  observer  dur- 
ing the  vears  1892  and  1893  is  as  follows  : 


Winter.      Spring. 

Summer. 

Autumn. 

Year. 

Monthly  mean  for  two  years,  59°         63° 

76° 

66° 

66° 

Average  minimum,  January  . 

.       37° 

Average  maximum,  July 

. 

.     105 

For  the  winter  of  1893-1894  a  record  of  temperature  and  rela- 
tive humidity  taken  at  the  Hotel  Terracina  at  midday — which  is 
just  before  the  Avarmest  and  driest  period  of  the  twenty-four  hours — 
is  as  follows  : 


Temperature. 

Relative 

Observations  taken 

Monthly 

Extreme 

Extreme 

Monthly 

humidity. 

at  12  M. 

mean. 

max. 

min. 

max. 

Per  cent. 

December,  1893     . 

.     55° 

76° 

35° 

63° 

51 

January,      1894     . 

.     47 

69 

26 

58 

46 

February 

.     51 

70 

32 

55 

43 

Winter  mean 

.     51 

46 

March    . 

.     55 

80 

31 

66 

44 

April 

.     62 

85 

40 

72 

39 

The  monthly  mean  temperature  for  1893  for  Redlands,  taken  by 
the  Southern  Pacific  Railroad,  arranged  by  seasons,  was  as  follows  : 
winter,  52°;  spring,  58°;  summer,  75°;  autumn,  58°;  annual,  61°; 
maximum,  103°;  minimum,  34°.  Monthly  mean  for  January,  54°; 
for  July,  77-^.  '': 

Rialto  (elevation,  1300  feet)  is  a  colony  four  miles  west  of  San 
Bernardino  and  twelve  or  fourteen  miles  from  Redlands.  The  fol- 
lowing imperfect  weather-record  is  given  as  a  basis  of  comparison.  It 
is  for  the  winter  of  1892-1893,  and  was  taken  from  The  Orange  Belt: 

Temperature,  November,  63°;  winter  (December,  January,  and 
February),  56°;  spring,  59°.  Relative  humidity,  November,  46 
per  cent.;  winter,  49  per  cent.;  spring,  60  per  cent. 


1  See  the  Climate  of  California. 


330 


MEDICAL  CLIMA  TO  LOG  Y. 


The  wind-movement  during  November  and  December  averaged 
5  miles  an  hour.      April  and  May  averaged  6  miles. 

The  Yucaipe  Valley,  eight  miles  northeast  of  Redlands,  is  worth 
the  attention  of  invalids  who  can  live  in  California.  Its  elevation 
is  from  2000  to  4000  feet,  a  little  too  high  for  orange-culture,  but 
well  adapted  for  deciduous  fruits.  It  is  slightly  more  protected 
from  the  influence  of  the  sea-winds  and  has  also  less  fog  than 
Redlands.      Its  rainfall  and  humidity  are  probably  about  the  same. 

Arrowhead  Hot  Springs.  Among  the  many  hot  springs  in 
San  Bernardino  County  one  of  the  best  known  and  most  resorted 
to  is  Arrowhead,  six  miles  northeast  of  the  city  of  San  Bernardino, 
■where  the  rude  outlines  of  an  arrowhead,  a  quarter  of  a  mile  in 
length  and  350  feet  across,  are  conspicuous  on  the  side  of  the  moun- 
tain. Here  are  twenty-five  springs,  at  an  elevation  of  nearly  2000 
feet,  with  temperatures  varying  from  140°  to  193°  F.  An  analysis 
of  the  principal  spring  (temperature  193°)  made  by  Professor  E.  W. 
Hilgard,  University  of  California,  is  as  follows: 


Potassium  sulphate 

Sodium  sulphate 

Sodium  chloride 

Lithium 

Calcium  sulphate 

Calcium  carbonate 

Barium 

Strontium  . 

Magnesium  sulphate 

Magnesium  carbonate 

Silica 

Organic  matter  . 

Total  solid  content 
Free  sulphuretted  hydrogen 


Grains  per  gallon. 

.       4.00 

.     42.47 

.       8.17 

.    strong  test 

.       1.34 

.       1.34 

.   a  faint  test 

well  marked 

0.14 

0.32 

4.94 

trace 


63.39 
644  cub.  in. 


The  hotel  is  situated  at  the  entrance  to  a  cailon,  2000  feet  above 
the  sea,  and  commands  enchanting  views.  Baths  are  given  in  vapor, 
hot  mineral  water,  and  the  mud  poultice. 

Seven  Oaks,  known  also  as  the  Lewis  Ranch,  is  a  camp  in  the 
Santa  Ana  Canon,  about  twenty-four  miles  from  Redlands,  reached 
by  a  mule-train.  The  elevation  is  4800  feet.  Season  extends  from 
May  to  October.  There  are  four  log-cabins  and  several  tents.  Food 
plain   but  wholesome.      Some  brook-trout  and  small  game  can  be 


PACIFIC  SLOPE  REGION.  331 

found.  There  is  a  good  cold-water  mineral  spring,  the  ingredients 
being  principally  iron  salts. 

Beaumont  (elevation,  2560  feet ;  population,  200).  Sixteen 
miles  east  of  Redlauds,  on  the  Southern  Pacific  llailroad,  is  an 
almost  deserted  '^  boom '"town  of  the  era  of  1888.  At  that  time 
twenty-seven  miles  of  streets  were  laid  out,  trees  were  planted,  ex- 
cellent water  was  brought  from  a  canon  in  the  foot-hills  four  miles 
west  of  the  town,  a  good  hotel  built,  and  other  improvements  pro- 
jected ;  but  it  was  started  on  a  falling  market  and  "  busted"  early 
in  its  career.  Beaumont  has  decided  natural  advantages,  particu- 
larly for  invalids.  It  is  situated  on  the  southern  side  of  a  valley 
twelve  miles  long  by  six  miles  wide.  It  has  warmer  summers  and 
colder  winters  than  the  coast-region,  but  is  drier  and  freer  from  fog 
than  the  lower  valleys  at  the  foot  of  the  mountains.  In  the  summer 
the  sea-wind  blows  over  sixty  miles  of  land  before  reaching  Beau- 
mont, thus  losing  much  of  its  moisture  and  coolness.  In  winter  the 
prevailing  wind  is  from  the  east,  blowing  from  the  distant  desert 
through  the  San  Gorgonio  Pass.  This  wind  is  dry  and  healthful, 
but  tiresomely  persistent.  It  can  fortunately  be  avoided  to  a  great 
extent  by  getting  in  the  shelter  of  the  foot-hills  that  form  the  eastern 
boundary  of  the  valley.  The  air  is  quite  dry  and  pure  and  invigor- 
ating, and  at  night  fairly  free  from  dampness. 

The  annual  rainfall  is  18  inches,  divided  as  follows:  winter, 
9.87  inches;  spring,  6.84  inches;  summer,  0.12  inch;  autumn, 
1.22  inch.  There  are  no  records  of  relative  humidity;  but  as 
there  is  almost  entire  immunity  from  fog  the  air  is  perceptibly  less 
moist  than  at  Los  Angeles.  A  yearly  average  would  probably  be 
near  60  per  cent,  or  below  it.  The  highest  record  of  temperature 
at  the  Highland  Home,  four  miles  northeast  of  the  postoffice,  is 
104°  and  the  lowest  36°.  At  the  railroad  station  the  extremes  in 
1888  were  104°  and  24°.  The  mean  for  January  was  41°;  for  July, 
77°.     Average  for  the  year,  62°. 

For  1893  the  mean  monthly  temperature,  taken  at  the  Southern 
Pacific  Railroad  station,  was  as  follows,  by  seasons :  winter,  53°; 
spring,  57°;  summer,  78°;  autumn,  63°;  annual,  63°;  maximum, 
102°;  minimum,  30°.  The  monthly  mean  for  January  was  58°, 
and  for  July  80°. 

The  accommodations  for  visitors  are  poor,  the  hotel  having  been 
closed  for  years. 

A  few  miles  west  of  Beaumont  are  benches  of  tableland  at  au 


332  MEDICAL  CLIMATOLOGY. 

altitude  of  4000  aud  5000  feet,  aud  even  higher.  On  the  side  of 
San  Jacinto  Mountain,  fourteen  miles  southeast  of  Beaumont,  is  the 
Stra-wberry  Valley,  a  well-known  summer-resort,  with  an  eleva- 
tion of  6000  feet.     It  has  fair  accommodations. 

Banning-  (elevation,  2300  feet ;  population,  300).  Six  miles 
east  of  Beaumont  is  the  town  of  Banning,  which  has  beeu  resorted 
to  by  invalids,  although  its  position  in  the  San  Gorgonio  Pass  ren- 
ders it  difficult  to  escape  the  trying  desert-winds  that  blow  in  from 
the  east.  There  are  a  number  of  canons  north  of  the  town  where 
the  wind  would  be  less  violent. 

Banning  has  a  resident  physician,  a  fairly  good  hotel,  and  several 
stores. 

Palm  Springs.  On  the  eastern  slope  of  the  San  Jacinto  range, 
aud  on  the  edge  of  the  desert,  five  miles  from  the  Southern  Pacific 
Kailroad  and  thirty-fiv^e  miles  southeast  of  Banning,  is  the  winter- 
resort  of  Palm  Springs.  The  elevation  is  about  580  feet  above  the 
sea.  The  sheltered  lands  of  Palm  Vallev  produce,  under  irrigation, 
fruits  and  vegetables  several  weeks  earlier  than  is  possible  directly 
within  the  sweep  of  the  Pacific  Ocean  winds.  Palms,  figs,  oranges, 
lemons,  and  dates  grow  luxuriantly.  The  winter  climate  is  warm 
and  mild.  A  copious,  hot  sulphurous  mineral  spring  flows  here, 
whence  comes  the  name  of  the  settlement.  Palm  Springs  has 
warm  winters  and  scorching  summers. 

Indio  is  a  station  on  the  Southern  Pacific  Railroad  one  hundred 
and  twenty-seven  miles  east  of  Los  Angeles.  It  is  situated  on  the 
edge  of  the  great  depression  in  the  Colorado  Desert,  which  reaches 
in  one  place  a  depth  of  360  feet  below  the  level  of  the  sea.^  This 
basin  is  130  miles  in  length  by  30  miles  in  average  width.  At 
Salton,  on  the  Southern  Pacific  Railroad,  the  surface  of  the  earth 
is  covered  with  a  crust  of  salt  four  inches  thick  for  nearly  ten  miles 
square. 

Indio  is  near  the  northern  rim  of  the  basin,  aud  is  50  feet  below 
the  level  of  the  sea.  This  is  the  most  arid  portion  of  America,  the 
annual  rainfall  being  about  2J  inches.  The  temperature  for  a  por- 
tion of  the  year  1894  was  as  follows  : 

1  Indio.    Walter  Liudley,  in  New  York  Medical  Record,  1888. 


PACIFIC  SLOPE  REGION.  33,^ 

Extreme  Extreme  Monthly 


November  . 

.     104° 

46° 

70' 

December   . 

.       79 

40 

55 

January 

.       83 

23 

54 

February     . 

.       90 

82 

45 

March 

.     102 

86 

64 

April  . 

.     100 

53 

75 

The  highest  temperature  during  the  year  was  117°  and  the  lowest 
23°. 

Dr.  Lindley  gives  the  mean  temperature  taken  for  the  month  of 
January,  1893,  as  follows:  7  a.m.,  45°;  2  p.m.,  83°;  9  p.m.,  53°. 
No  records  of  the  humidity  at  Indio  have  been  published,  but  the 
air  is  very  dry  and  warm, 

Indio  is  an  oasis  in  the  desert.  Water  is  obtained  from  surface- 
wells,  aud  also  in  great  quantity  from  artesian  wells  sunk  only  to  a 
depth  of  115  feet.  By  means  of  irrigation  trees  and  plants  and 
flowers  are  grown.  Near  the  mountains  are  date-palms,  growing 
sometimes  to  a  height  of  eighty  feet. 

There  is  a  good  small  hotel,  and  a  limited  number  of  cottages 
have  been  built  for  visitors,  but  the  accommodations  are  not  vet 
very  extensive. 

Hesperia  (elevation,  3100  feet)  ;  Victor  (2700  feet)  on  the  line 
of  the  Southern  California  Railroad.  The  climate  of  the  country 
in  the  foot-hills  on  the  leeward  side  of  the  mountains  is  worthy  of 
notice. 

The  Mojave  Desert  is  a  vast  plaiu  lying  north  of  the  San  Bernar- 
dino rauge  of  mountains,  aud  extending  from  the  Colorado  River  on 
the  east  to  Ventura  County  on  the  west.  It  is  300  miles  east  aud 
west  and  from  20  to  200  miles  north  and  south — a  mesa  or  table- 
laud,  most  of  it  2000  feet  above  the  sea,  except  the  northeastern 
portion,  which  is  below"  sea-level  and  is  known  as  the  Death  Val- 
ley. Close  up  to  the  mountains  the  soil  is  fertile  under  the  appli- 
cation of  water,  which  can  be  obtained  by  means  of  reservoirs  on 
the  mountains  and  by  using  the  Mojave  River.  This  watershed  is 
3000  to  6000  feet  above  the  sea,  and  has  a  rainfall  on  the  mountaiu- 
tops  of  about  40  inches  per  annum. 

The  climate  on  the  north  and  east  slopes  of  the  mountains  in 
Southern  California  is  the  driest,  as  it  is  protected  from  the  trade- 
wind  coming  from  the  west  or  southwest,  which  is  a  moisture- 
bearing  wind.      The  rainfall  is  about  15  inches.      The  humidity  is 


334  MEDICAL  CLIMATOLOGY, 

less  on  that  slope,  and  at  au  elevation  above  2000  feet  the  nights 
are  usually  cool.  Tliere  is  occasionally  a  parching,  dry  north  wind 
from  the  desert  that  is  very  trying,  although  healthful.  It  is  in- 
tensely hot  iu  summer,  but  drier  both  in  winter  and  summer  than 
localities  on  the  coast-side  of  the  mountains. 

Artesian  wells  are  already  used  to  a  limited  extent  at  Hesperia  to 
furnish  a  supply  of  water,  and  the  number  of  fruit-ranches  on  this 
upland  edge  of  the  desert  is  increasing. 

At  Dag-gett  (2000  feet)  the  record  of  temperature  is:  monthly 
mean,  winter,  47°;  spring,  57°;  summer,  84°;  autumn,  71°;  aver- 
age for  the  year,  6o°;  maximum,  104°;  minimum,  20°.  Annual 
rainfall,  4  inches. 

The  Antelope  Valley,  fifty  miles  west  of  Hesperia  and  Victor, 
has  much  the  same  characteristics.  Lancaster  (2300  feet)  is  the 
principal  town. 

There  are  no  accommodations  for  visitors  in  these  places.  Tney 
are  referred  to  here  in  order  to  preserve  a  record  of  the  climate  of 
this  region. 

Ojai  Valley  (average  elevation,  900  to  1200  feet).  NordhoflF 
(elevation,  1200  feet;  population,  800)  is  the  principal  town. 

This  retreat  in  the  mountains  is  in  Ventura  County,  fifteen  miles 
north  of  the  town  of  Santa  Buena  Ventura,  with  which  it  is  con- 
nected by  a  daily  stage. 

The  valley  is  a  ^'pocket"  in  the  mountains,  varying  in  width 
from  two  to  four  miles  and  entirely  surrounded  by  the  San  Rafael 
and  Santa  Inez  ranges,  which  rise  on  the  east  to  a  height  of  6000 
feet.  It  is  thus  well  sheltered  from  harsh  winds  and  partly  also 
from  the  sea-fogs.  The  southern  portion  of  the  valley  is  about  five 
miles  long,  and  the  northern  portion,  in  which  Xordhotf  is  situated, 
about  ten  miles  Ions;. 

Daring  the  spring  of  1895  the  fogs  in  Nordhoff  averaged  ten  for 
each  month,  clearing  usually  before  9  a.m.  and  always  by  11  o'clock. 
During  the  winter  months  the  fogs  were  not  so  prevalent.  Directly 
on  the  coast  the  fogs  are  usually  more  severe  and  protracted  than 
they  are  inland.  The  mean  temperature  during  the  winter  is  a  little 
higher  in  the  valley  than  it  is  on  the  seashore,  although  there  is  an 
occasional  lower  minimum.  During  the  year  1892  the  temperatures 
during  the  mouths  of  winter  and  spring  were  as  follows  • 


PACIFIC  SLOPE  REGION.  335 


1892. 

Mean. 

Max. 

Mln. 

January 

52° 

78° 

27° 

February     . 

53 

79 

... 

March 

54 

85 

28 

April  .... 

56 

82 

31 

May    .... 

62 

100 

34 

December    . 

50 

77 

25 

During  the  year  1892  the  maximum  temperature  was  110°  in 
August  and  the  minimum  25°  in  December. 

During  the  year  1893  the  maximum  was  100°  in  August  and  the 
minimum  25°  in  December.  The  mean  annual  temperature  was  58°. 
Monthly  mean  for  January,  52°;  for  July,  70°.  The  temperature 
by  seasons  for  1893  was  as  follows  :  winter,  51°;  spring,  54°;  sum- 
mer, 68°;  autumn,  58°. 

From  a  detailed  report  of  the  weather  taken  at  the  Gaily  Cot- 
tages, one  mile  from  the  centre  of  NordhoflF,  during  the  year  1895, 
for  the  months  of  winter  (December,  January,  and  February)  and 
spring  (March,  April,  and  May),  the  following  particulars  were 
obtained  : 


Temperature 

Mean 

relative 

humidty. 

Per  ct. 

66 

65 

Fogs. 

Mornings. 

4 

29 

Winter, 
Spring, 

Mean 
max. 

67° 

71 

Mean 
Min. 

38° 
44 

Monthly 
mean. 

52° 

57 

Rainy 

days. 

14 

8 

The  relative  humidity  was  based  on  three  daily  observations 
taken  at  9,  1,  and  6  o'clock.  For  winter  the  humidity  is  for  two 
months  only,  January  and  February.  The  extreme  maxinnim  tem- 
perature was  for  winter,  85°;  spring,  95°.  Extreme  miuimum 
temperature  for  winter,  26° ;  spring,  32°.  The  number  of  days  over 
80°  was  7  in  winter  and  15  in  spring.  Number  of  days  below  32°, 
17  in  winter  and  2  in  spring. 

The  mean  annual  rainfall  at  Nordhoff,  taken  from  a  report  pub- 
lished .several  years  ago  by  Geueral  A.  W.  Greely,  then  Chief  Signal 
Officer,  entitled  "  Rainfall  in  California,  etc.,  for  from  2  to  40  years," 
is  as  follows : 

Rainfall,  annual  mean 27.84  inches. 

"  winter       " 12.82 

"  spring       " 9.23 

This  shows  the  amount  of  annual  rainfall  to  be  about  10  inches 
greater  than  at  Santa  Barbara. 


336  MEDICAL  CLIMATOLOGY. 

In  the  Ojai  Valley  are  fruit-rauches  and  mountain  walks  and 
rides.  There  are  pleasant  boarding-houses  and  cottages.  Trout- 
fishing  can  be  found  in  the  vicinity.  There  are  several  beautiful 
canons,  with  fine  oak  trees  and  a  wealth  of  flowers  and  vines.  It 
has  an  agreeable  winter  climate,  but  the  summers  are  hot  and  night- 
fogs  are  frequent  at  that  season. 

In  Waterfall  Canon,  five  miles  from  Nordhoff,  are  the  Ojai  Hot 
Spring's,  situated  at  an  elevation  of  1000  feet.  They  are  soda 
springs,  carbonated  and  sulphurated,  and  flow  about  50,000  gallons 
per  hour  at   temperatures  varying  from  60°  to  101°  F. 

Dr.  Winslow  Anderson,  of  San  Francisco,  states  that  these  waters 
contain  sodium,  potassium,  and  magnesium  carbonates  and  sul- 
phates, calcium  and  ferrous  carbonates,  silicates,  carbonic  anhy- 
dride, and  sulphuretted  hydrogen  gases. 

In  Matilija  Canon,  six  miles  from  Nordhoff,  are  twenty-eight 
springs,  known  as  the  Matilija  Hot  Springs.  They  are  mostly 
sulphuretted,  and  flow  about  5000  gallons  per  hour  at  temperatures 
ranging  from  35°  to  160°  F.     There  is  a  resort  at  the  springs. 

Other  canons  are  the  San  Antonio  Caiion  and  the  Santa  Paula 
Caiion  to  Santa  Paula,  fourteen  miles  distant. 

Sespe  Valley  (elevation  about  2000  feet)  is  fifteen  miles  northeast 
of  Nordhoff.  This  valley  is  reached  by  a  mountain-trail,  suitable 
only  for  animals  and  foot-passengers,  which  crosses  the  range  ten 
miles  north  of  Nordhoff  at  an  elevatioo  of  5000  feet.  The  Sespe 
River  shrinks  to  almost  a  brook  during  the  rainless  summer  season. 
The  water  is  alkaline.  Water  can  also  be  obtained  from  springs. 
It  is  a  rough  country,  without  conveniences,  there  being  but  few 
ranches.  It  has  a  good  climate,  hotter,  but  Avith  fewer  foggy  days 
than  on  the  coast.  It  is  cooler  than  the  Ojai  Valley.  This  region 
is  well  adapted  for  camping-out,  and  is  a  change  from  the  climate 
of  the  seacoast. 

Pine  Mountain  (elevation,  6000  feet)  twelve  miles  north  of  Sespe, 
is  also  said  to  offer  attractions  for  campers. 

Santa  Barbara  (population,  6000).  The  coast  of  California, 
just  south  of  latitude  35°,  suddenly  makes  a  sharp  turn  at  Point 
Conception,  and  runs  east  and  then  southeast  until  the  Mexican 
frontier  is  reached.  The  great  Pacific  drift-current,  which  is  by 
many  writers  held  responsible  for  so  many  peculiarities  of  the  Pacific 
coast  climate,  not  being  prepared  for  such  a  sudden  change,  shoots 
straight  on  south  and  washes  the  Californian  shore  no  more.     Along 


PACIFIC  SLOPE  REGION.  337 

these  sheltered  waters  are  situated  the  ooast-resorts  of  Southern  Cali- 
foraia,  those  facing  on  the  Santa  Barbara  Channel  being  especially 
famous  for  a  climate  rivalling  or  surpassing  that  of  the  Riviera, 
while  the  interior  resorts,  on  the  border  of  the  desert,  are  said  to 
have  a  climate  ''  similar  in  winter  to  that  of  Egypt".  Rain  falls 
only  during  the  winter  months,  and  the  mildness  and  equability  of 
the  temperature  on  the  coast  render  it  desirable  for  invalids  to 
whom  the  moisture  is  not  objectionable. 

The  town  of  Santa  Barbara  (latitude,  34°  28'  north)  is  forty  miles 
east  of  Point  Concepcion,  situated  on  a  plain  that  rises  three  or  four 
hundred  feet  from  the  ocean  to  the  foot-hills.  This  whole  plain  is 
eighty  miles  long,  with  a  width  of  about  four  miles.  To  the  north 
the  Santa  Inez  range  reaches  a  height  of  3000  feet,  affording  pro- 
tection from  cold  northern  and  western  winds.  The  Channel  Islands, 
twenty-five  miles  south,  afford  a  slight  break  against  strong  south- 
west winds.  "  Here  is  our  Mediterranean.  Here  is  our  Italy.  It 
is  a  Mediterranean  without  marshes  and  without  malaria.  It  is  a 
Mediterranean  with  a  more  equable  climate,  warmer  winters,  and 
cooler  summers  than  the  north  Mediterranean  shore  can  offer.  It 
is  an  Italy  whose  mountains  and  valleys  give  almost  every  variety 
of  elevation  and  temperature.  But  it  is  our  commercial  Mediterra- 
nean. The  time  is  not  distant  when  this  corner  of  the  United  States 
will  produce  in  abundance,  and  year  after  year  without  failure,  all 
the  fruits  and  nuts  which  for  a  thousand  years  the  civilized  world 
of  Europe  has  looked  to  the  Mediterranean  to  supply."^ 

There  is  little  or  no  sand  in  the  soil  around  Santa  Barbara ;  it  is 
alluvial  or  adobe,  and  extremely  fertile  and  moist.  Crops  are 
grown  in  this  portion  of  the  State  without  requiring  irrigation. 

The  town  is  supplied  with  water  from  Mission  Canon  and  from 
tunnels  run  into  the  mountains.  The  water  contains  lime,  and 
should  be  boiled  before  being  used.  There  are  street-car  lines, 
electric  lights,  and  sewers  in  the  principal  streets.  Santa  Barbara 
has  a  good  beach  for  bathing  or  driving.  The  fishing  is  said  to  be 
excellent  around  the  islands. 

Sergeant  James  A.  Barwick,  of  the  United  States  Signal  Corps, 
the  Director  of  the  California  State  Weather  Service,  has  prepared 
a  series  of  '' climatic  comparisons  of  Santa  Barbara  with  San  Remo 
and  Men  tone,"  based  on  the  averages  of  several  years.     A  brief 

1  Our  Italy.    Charles  Dudley  Warner. 
22 


338  MEDICAL  CLIMATOLOGY. 

extract  shows  the  temperature  for  January  to  be:  Sau  Remo,  47°; 
Mentone,  48°;  Santa  Barbara,  54°.  For  July  :  San  Remo,  74°; 
Meatone,  75°;  Santa  Barbara,  65°.  A  further  examination  of  the 
annual  records  shows  that  the  resorts  on  the  Mediterranean  Riviera 
have  also  more  cloudy  days  during  the  year,  twice  as  many  stormy 
days,  and  about  twice  as  much  annual  rainfall,  as  well  as  more  wind 
than  Santa  Barbara;  but  they  are  comparatively  drier,  as  indicated 
by  an  almost  complete  absence  of  fog. 

Along  the  coast  of  California  the  daily  variation^  of  temperature 
during  the  winter  months  is  exceedingly  small.  Comparing  the 
winter  climate  of  !N^ice  with  that  of  the  Californian  coast,  General  A. 
W.  Greely  wrote,  a  few  years  ago,  in  an  article  in  Scribner^s  Maga- 
zine^ that  while  Nice  generally  excelled  California  in  equability  of 
temperature,  yet  at  irregular  intervals  cold,  dry,  piercing  winds 
swept  over  the  place,  bringing  sharp  and  sudden  changes  of  20°  or 
more  in  a  day.  He  considered  Nice  inferior  as  having  lo-.ver  tem- 
perature, higher  winds,  and  occasionally  snow  and  ice,  which  are 
unknown  on  the  coast  of  Southern  California." 

The  equability  of  the  temperature  at  Santa  Barbara  during  the 
year  is  shown  by  the  record  for  the  seasons  :  mean  monthly  tem- 
perature for  winter,  54°;  spring,  58°;  summer,  65°;  autumn,  63°. 
There  is  an  average  number  of  26  days  above  80°  and  6  days 
below  40°.  The  yearly  mean  of  relative  humidity  is  73  per  cent. 
Average  number  of  cloudy  days,  73 ;  stormy  days,  28  (means  for 
eight  years).  Annual  rainfall  averages  18  inches.  The  record  for 
twenty-four  years  shows  an  increase  of  32  per  cent,  in  the  last  twelve 
years  over  the  first  twelve.  It  rains  partly  at  night  and  occasionally 
for  nine  or  ten  days  in  succession,  giving  about  half  a  year's  precipi- 
tation during  that  time.^ 

There  are  rarely  during  the  year  more  than  two  or  three  unpleas- 
ant days  of  wind-  and  dust-storms.  These  may  come  in  March. 
The  least  windy  period  of  the  year  is  from  October  into  February. 
The  wind-movement  is  very  moderate,  the  annual  average  for  seven 
years,  recorded  by  the  local  observer,  being  nearly  4  miles  per  hour. 

There  are  a  number  of  foggy  days,  the  damp  and  depressing  in- 
fluence of  which  is  bad  for  invalids. 

1  See  Tables  V.  to  IX.  and  XIV. 

-  Where  Shall  We  Spend  Our  Winters.     General  A.  W.  Greely,  in  Scribner's  Magazine, 
November,  188S. 

2  For  further  consideration  of  the  coast  climate,  see  the  Climate  of  California,    and  San 
Diego. 


PACIFIC  SLOPE  REGION.  339 

At  Santa  Barbara  duriog  the  year  1894  there  were  recorded  by 
the  local  observer  73  foggy  mornings,  the  greatest  number  being  in 
November  (12)  and  July  (16).  The  number  was  small  from  the 
end  of  November  to  April. 

By  seasons,  Santa  Barbara,  1894,  foggy  mornings  : 

Winter     .         .       5  days.  Summer  .         .     2()  days. 

Spring      .         .     14     "  Autumn  .         .     28     " 

The  nights  are  so  cool  as  to  make  blankets  necessary.  There  are 
usually  about  thirteen  nights  during  the  year  above  60°. 

Dr.  C.  B.  Bates,  of  Santa  Barbara,  referring  to  the  climate,  warns 
delicate  persons  to  beware  of  the  chill.  "Just  before  sunset  the 
temperature  rapidly  falls,  and  the  invalid  at  this  time  should  re- 
main in  the  house,  or,  if  out  of  doors  and  not  briskly  exercising, 
should  put  on  an  overcoat.  Indeed,  although  the  climate  of  Santa 
Barbara  is  warm,  it  is  not  hot ;  flannels  next  the  skin,  with  moder- 
ately warm  clothing,  can  and  should  be  worn  throughout  the 
year." 

This  Pacific  coast  climate  is  damp,  and  presents  its  claims  to 
sufferers  on  the  grounds  of  equable  temperature  and  sunshine.  It 
lacks  the  dry  air  and  tonic,  stimulating  qualities  of  the  elevated  in- 
land plains,  but  offers  less  shock  to  the  system  from  rapid  changes.^ 

Santa  Barbara  is  well  supplied  with  good  hotel  ana  boarding 
accommodations. 

The  temperature  of  the  sea- water  off  Santa  Barbara  varies  from 
60°  to  ^0^°  (the  warmest  record  being  made  in  September),  with  a 
yearly  mean  of  62°.  This  is  about  10°  cooler  than  the  sea-water 
off  the  coast  of  Southern  Florida  and  the  Bahamas. 

Santa  Barbara  Hot  Springs.  A  little  over  six  miles  northeast 
of  the  town  of  Santa  Barbara  are  the  Santa  Inez  Hot  Sulphurous 
and  Soda  Springs,  which  are  picturesquely  situated  1450  feet  above 
the  level  of  the  sea.  There  are  about  thirty  mineral  springs  in  all 
— sulphurous,  saline,  and  chalybeate — ranging  in  temperature  from 
99°  to  122°  F.    The  water  of  several  of  the  principal  springs  is  used 

1  Memorandum  showing  the  highest  and  lowest  yearly  records  of  temperature  for  several ' 
years  at  Santa  Barbara.    From  the  published  records  of  Hugh  D.  Vail,  Esq. 

Max.      Min.  Max.  Min. 

1885        ....      85'^  35°  1892 97.5°       37.5" 

1889  ....     107  33  1893 88  38 

1890  ....       98  33.5  1894 94  33 

1891  ....       96  33 


340  MEDICAL  CLIMATOLOGY. 

for  drinking  and  bathing  purposes.  An  analysis  of  the  Sulphur 
Springs  Nos.  1  and  2,  made  by  Dr.  Winslow  Anderson,  of  San 
Francisco,  is  as  follows  : 

Grains  in  one  gallon. 

Sodium  chloride 1.74 

Sodium  carbonate 2.17 

Sodium  sulphate 14.92 

Magnesium  sulphate 7.75 

Calcium  sulphate 6.03 

Aluminum  sulphate 2.90 

Arsenic       .........      trace 

Silica 1.18 

Sulphuric  acid trace 

Organic  matter trace 

Total  solids  .         .         .     35.95 

Carbonic  anhydride 19.14  cub.  in. 

Sulphuretted  hydrogen 9.16        " 

There  are  a  hotel  and  a  bath-house  at  the  Springs. 

Five  miles  from  Santa  Barbara  are  the  Montecito  Hot  Sulphur 
Springs,  situated  in  a  ravine  in  the  mountains  at  an  elevation  of 
1460  feet.     The  temperature  of  the  water  is  120°  F. 

Paso  Robles  (elevation,  800  feet ;  population,  1000).  The 
annual  "  Meteorological  Review"  of  the  State  of  California  for  the 
year  1891  contains  the  following  statement  relating  to  the  climate 
of  this  town,  taken  from  the  Pacific  Rural  Press: 

"  This  portion  of  the  Coast  Range  is  subject  to  greater  fluctua- 
tions than  has  been  heretofore  supposed.  The  mean  monthly  tem- 
perature can  never  be  used  as  conclusive  evidence  of  any  climate. 
Nothing  could  be  more  misleading  in  reference  to  the  climate  under 
consideration — a  climate  representative  of  many  higher  valleys  in 
the  California  Coast  Ranges.  The  station  is  situated  eighty  feet 
above  the  Salinas  River,  about  800  feet  above  the  sea-level  and 
forty  miles  due  east  of  Estero  Bay,  with  a  high  mountain-chain — 
the  Santa  Lucia — between. 

''There  are  many  places  in  the  district  where  the  thermometric 
variations  are  even  more  sudden  than  at  the  station.  .  .  .  The 
greatest  atmospheric  dryness,  in  October  and  December,  occurred 
when  a  north  wind  was  blowing.  The  hygrometer  was  exposed  on 
the  north  side  of  the  house,  so  that  the  conditions  were  favorable  to 
extreme  indications  ;  but  in  any  case  the  record  is  an  extraordinary 
one." 


PACIFIC  SLOPE  REGION. 


341 


The  table  given  is  for  each  month  in  the  year  (1890),  and  is  full 
of  details.  An  abstract  shows  the  mean  daily  range  of  temperature 
to  be  by  seasons:  winter,  21°;  spring,  26°  summer,  43°;  autumn, 
35°.  The  mean  range  of  humidity  was  :  winter,  44  ;  spring,  30 ; 
summer,  46  ;  autumn,  64  per  cent.  The  greatest  range  of  tem- 
perature was  in  January,  54°;  and  of  humidity  in  December,  80 
per  cent. 

The  monthly  mean  temperature  for  January  was  44°;  for  July, 
75°.  No  reference  was  made  in  the  report  to  cloudy  or  stormy 
days  or  to  the  wind-movement. 

By  seasons  (1890)  : 

Winter. 
Mean  monthly  temperature,     45° 
Mean  relative  humidity,  73  p.c. 

Total  rainfall,  10.89  in. 

The  mean  monthly  temperature  for  Paso  Robles  for  1893, 
arranged  by  seasons,  was  as  follows  :  winter,  43°;  spring,  55°; 
summer,  72°;  autumn,  55°;  annual,  56.25°;  maximum,  107°;  mini- 
mum, 20°.     Monthly  mean  for  January,  44°;  for  July,  75°. 

This  portion  of  the  Salinas  Valley  has  long  been  noted  for  its 
mineral  springs,  which  are  sulphurous  and  alkaline  and  both  hot 
and  cold,  ranging  in  temperature  from  59°  to  122°  F. 

Near  the  hotel  is  the  main  hot,  sulphuretted  spring,  which  flows 
5000  gallons  per  hour,  at  a  temperature  of  108°  F.  An  analysis 
made  bv  Dr.  Winslow  Anderson  in  1889  is  as  follows : 


Spring. 

Summer. 

Autumn. 

Year. 

58° 

74° 

57° 

59° 

80  p.c. 

50  p.c. 

58  p.c. 

65  p.c. 

3.09  in. 

0.00  in. 

0.00  in. 

13.98  in 

Sodium  chloride 
Sodium  bicarbonate 
Sodium  carbonate 
Sodium  sulphate 
Sodium  iodide    . 
Sodium  bromide 
Potassium  chloride 
Potassium  carbonate 
Potassium  iodide 
Potassium  sulphate 
Magnesium  bicarbonate 
Magnesium  carbonate 
Magnesium  sulphate  . 
Calcium  carbonate 
Calcium  sulphate 
Ferric  peroxide 


Grains  in  one  gallon. 

25.73 

41.19 

7.62 

7.25 
trace 
trace 

1.57 

2.05 
trace 
trace 


2.15 
5.11 
1.23 
2.94 
0.73 


342 


ME  Die  A  L  CLIMA  TOLOGY. 


Borates 

Lithates.     . 

Alumina 

Silica .... 

Iodides  and  bromides 

Oreanic  matter  . 


Total  solids 

Free  sulphuretted  hydrogen 
Free  carbonic-acid  gas 


Grains  in  one  gallon. 

trace 

trace 

0.25 

1.75 


1.90 


101.47 

3.75cub.in. 
8.90       " 


The  next  most  important  spring  is  tliat  used  for  the  mud-baths. 
It  is  sulphurous,  and  is  one  and  one-half  miles  from  the  hotel,  situ- 
ated on  the  edge  of  the  Salinas  River.  There  is  a  well-kept  road, 
shaded  with  oaks.  The  mud-springs  flow  collectively  about  6000 
gallons  per  hour.  The  temperature  varies  from  107°  to  122°  F. 
A  bath-house  with  necessary  facilities  has  been  erected. 

An  analysis  made  by  Dr.  Anderson  is  as  follows: 


Sodium  chloride 
Sodium  carbonate 
Sodium  sulphate 
Sodium  iodide    . 
Potassium  chloride 
Potassium  iodide 
Potassium  sulphate 
Magnesium  carbonate 
Magnesium  sulphate 
Calcium  carbonate 
Calcium  sulphate 
Ferrous  sulphate 
Alumina     , 
Manganese  salts 
Silica. 

Lithium  salts 
Organic  matter  . 


Total  solids 

Ammonia  and  nitrogen 
Free  sulphuretted  hydrogen 
Free  carbonic-acid  gas 


Grains  in  one  gallon. 
83.72 

7.41 
36.97 
trace 

3.19 
trace 

0.82 

4.25 

1.13 

2.10 
15.75 

0.23 

0.80 
trace 

0.25 
trace 

7.14 


166.02 

trace 

4.16  cub. in. 
42.50       " 


About  200  yards  north  of  the  mud-baths  is  the  "  soda  spring  ". 
Its  temperature  is  77°.     Total  solids,  84  grains  in  one  gallon.     The 


PACIFIC  SLOPE  REGION. 


343 


''Garden  Spring"  is  carbonated  water,  containing  76  grains  of  total 
solids  to  one  gallon. 

Beyond  the  "  Garden  Spring  "  is  the  ''  Sand  Spring,"  an  alkalo- 
sulphurous,  lightly  carbonated  water,  containing  190  grains  of  total 
solids.     Temperature,  79°  F. 

A  quarter  of  a  mile  or  more  southeast  of  the  hotel  is  the  "  Iron 
Spring".     Temperature,  64°.    Total  solids,  79  grains  in  one  gallon. 

Two  and  one-half  miles  southeast  of  Paso  Robles  are  the  Santa 
Isabel  Hot  and  Cold  Sulphur  Springs,  which  are  situated  in  a  small 
canon  about  one  mile  east  of  the  Salinas  River,  at  an  elevation  of  1000 
feet  above  the  sea.  There  are  three  warm  sulphur  springs,  almost 
identical  in  composition.  An  analysis  by  Dr.  Anderson  of  Spring 
No.  1  is  as  follows: 

Temperature,  96°  F.  Flows  20,000  gallons  per  hour.  The  water 
is  tonic,  antacid,  diuretic,  aperient,  and  alterative.  It  resembles 
the  Arkansas  Springs. 


Sodium  chloride 
Sodium  bicarbonate 
Sodium  carbonate 
Sodium  sulphate 
Sodium  iodide    . 
Potassium  bromide 
Potassium  iodide 
Potassium  chloride 
Potassium  carbonate 
Magnesium  carbonate 
Magnesium  sulphate 
Calcium  carbonate 
Calcium  sulphate 
Manganese  carbonate 
Ferrous  carbonate 
Borates 
Alumina     . 
Barium  salts 
Silica . 
Organic  matter  . 

Total  solids 
Free  sulphuretted  hydrogen 
Free  carbonic-acid  gas 


Grains  in  one  gallon. 

18.10 

29.04 

6.91 

7.25 
trace 
trace 
trace 
trace 

0.83 

6.16 

4.85 

2.45 

2.32 

0.13 

0.98 
trace 

0.73 
trace 

1.68 
trace 


81.43 

4.65  cub. in. 
11.76       " 


A  quarter  of  a  mile  further  up  the  little  caiion  are  the  cold  or 
White  Sulphur  Springs.  They  vary  in  temperature  from  56°  to  60° 
F.,  and  are  much  lighter  than  the  warm  sulphurous  water. 


344  *    MEDICAL  CLIMATOLOGY. 

Monterey  is  one  huudred  and  twenty-five  miles  south  from  San 
Francisco  by  rail  and  eighty-five  mile.s  by  sea.  It  is  one  of  the 
most  interesting  of  the  old  Spanish  settlements  on  the  Pacific  coast. 
There  is  a  fine  drive  around  the  peninsula  on  which  the  town  lies, 
affording  views  of  the  beautiful  Bay  of  Monterey  and  of  the  Pacific 
Ocean.  There  is  said  to  be  good  fishing  in  the  bay  and  in  the 
Carraelo  River. 

The  Hotel  del  Monte  is  one  of  the  largest  and  most  attractive 
hotels  in  America.  In  appearance  it  resembles  an  immense  country 
mansion  placed  in  a  large  park.  The  main  portion  of  the  hotel  is 
340  feet  in  length  by  110  feet  in  width.  The  entire  structure  con- 
tains 430  rooms,  and  is  surrounded  by  wide  verandas. 

The  grounds  around  the  hotel  consist  of  a  plat  of  126  acres,  de- 
voted to  lawns  and  flower-gardens,  while  the  entire  park  contains 
7000  acres,  containing  groves  of  oaks,  pines,  and  cedars. 

The  roads  are  well  kept,  and  boating  and  bathing  may  be  enjoyed. 

The  climate  of  Monterey  is  exceedingly  humid,  and  therefore  quite 
equable.  The  mean  temperature  for  several  years  for  the  month  of 
January  is  50°  and  for  July  65°.  In  1894  it  was:  January,  46°; 
July,  60°;  annual  mean,  56°;  maximum,  88°;  minimum,  26°. 

The  mean  annual  rainfall  is  14.4  inches.  The  highest  record  is 
21.4  inches  and  the  lowest  9  inches. 

Fogs  are  more  prevalent  than  on  the  coast  south  of  Point  Concep- 
cion. 

Napa  Valley  ;  Atlas  Peak  (elevation,  1500  feet).  It  is  curious 
to  find  the  best  record  for  dryness  in  California  credited  to  a  portion 
of  the  State  only  from  forty  to  sixty  miles  north  of  San  Francisco, 
on  the  slope  of  the  Napa  Valley,  which  is  noted  for  its  wine-pro- 
ducing qualities.  Dr.  J.  S.  Hittell  states  that  the  average  percent- 
age of  relative  humidity  at  Atlas  Peak,  east  of  Napa  Ridge,  about 
fifty  miles  from  the  sea,  is  for  summer  (half-year),  39  per  cent.; 
winter  (half-year),  51  per  cent.;  year,  45  per  cent.,  or  about  the 
same  as  Denver.  The  temperature,  howev^er,  is  usually  higher  than 
in  Denver,  especially  in  winter.  Dr.  Hittell  credits  Los  Angeles 
with  an  annual  relative  humidity  of  65  per  cent,  (which  is  low), 
and  Santa  Barbara  and  San  Diego  are  rated  still  higher.  He  says  : 
"■  The  figures  here  given  show  that  Atlas  Peak  and  Blake's,  in  the 
coast  mountains  of  California,  are  unequalled  in  their  combination 
of  dry  atmosphere  with  a  mild  temperature  in  winter  and  summer, 
and  a  desirable  elevation.     No  observations  for  relative  humidity 


PACIFIC  SLOPE  REGION.  345 

have  been  kept  at  any  other  part  in  the  Coast  Mountains,  but 
there  are  doubtless  many  places  in  that  range  south  of  the  Silver 
Gate  with  conditions  equally  favorable,  as  will  probably  appear  in  a 
few  years."^ 

Atlas  Peak  has  a  mean  temperature  in  January  of  50°;  in  July^ 
74°.  Dr.  James  Blake  states  that  at  his  place,  2100  feet  above  the 
sea,  near  Mount  St.  Helena,  the  orange-trees  suffered  less  one  season 
than  at  Los  Angeles,  where  a  temperature  of  23°  was  reported, 
while  at  Dr.  Blake's  residence  the  thermometer  did  not  go  below 
29°.  Mount  St.  Helena,  4300  feet  high,  is  an  extinct  volcano  with 
a  flat  top.  The  distance  by  travelled  route  from  San  Francisco  is 
eighty-three  miles — the  last  twelve  being  done  on  horseback.  It 
commands  extensive  views.  On  the  east  of  Napa  Ridge,  Howell 
Mountain,  seven  miles  north  of  the  town  of  St.  Helena,  five  miles 
south  of  Blake's,  and  eight  miles  from  Atlas  Peak,  has  five  square 
miles  of  nearly  level  land  at  an  elevation  of  1800  feet.  There  are 
streams  and  timber,  and  it  is  a  favorite  place  for  camping.  Frosts 
are  severe  in  the  spring,  but  rare  in  the  autumn. 

The  resort  of  Napa  Soda  Springs  is  on  the  west  side  of  the  same 
ridge,  1200  feet  above  the  sea  (see  page  347).  It  is  five  miles  from 
Atlas  Peak.  There  is  a  hotel  at  the  springs,  but  the  Atlas  Peak 
visitors  must  camp  out.  This  last-named  location  was  selected  by 
the  State  Board  of  Health  in  1880  as  the  best  in  the  State  for  a 
hospital  for  consumptives.  The  annual  rainfall  at  Napa  City  is  22 
iuches ;  at  Calistoga,  30  inches.  The  east  Napa  Ridge  has  less 
frost  than  the  fertile  Napa  Valley  below  it. 

The  meteorological  record  for  seventeen  years,  kept  at  the  Napa 
State  Asylum  for  the  Insane,  shows  the  mean  temperature  and  rain- 
fall for  that  place  to  be  by  seasons  as  follows  : 

Winter.       Spring.    Summer.    Autumn.       Year. 
Monthly  mean  temperature,        45°  55°  63°  57°  55° 

Rainfall  (seasonal),  14.42in.    7.66 in.  0.32 in.    3.92in.    26.32in. 

Monthly  mean  temperature,  January,  44°  ;  mean  minimum,    36° 
Monthly  mean  temperature,  July,         64  ;  mean  maximum,    76 

Clear  Lake  is  an  attractive  body  of  water  twenty-five  miles  by 
six,  and  1200  feet  above  the  sea.  Chief  town,  Lakeport,  thirty-two 
miles  from  Cloverdale, 

1  Handbook  of  Pacific  Coast  Travel.    J.  S.  Hittell,  M.D.,  San  Francisco,  1887. 


346  MEDICAL  CLIMATOLOGY. 

Cobb  Valley  (3000  feet  elevation),  tweuty-five  miles  north  of 
Calistoga,  is  a  favorite  retreat  for  hunters  and  campers. 

In  Lake  County  are  numerous  springs,  between  2000  and  3000 
feet  above  the  sea,  having  virtues  of  mineral  waters  and  climate  not 
as  yet  known  with  exactness. 

Lake  Tahoe  is  one  of  the  most  delightful  summer-resorts  of 
California.  It  is  situated  on  the  State-line  between  California  and 
Nevada,  fourteen  miles  by  stage  south  of  Truckee,  on  the  Central 
Pacific  Railroad.  The  elevation  of  the  lake  is  6200  feet.  It  is 
twenty-one  miles  long  by  twelve  miles  wide  and  1500  feet  deep. 
The  water  is  very  clear,  pure,  and  cold,  and  never  freezes.  It  is  sur- 
rounded by  mountains.  Steamers  ply  on  the  lake.  There  are  hotels 
at  Tahoe  City,  on  the  west  shore,  and  at  Glenbrook,  on  the  east 
shore,  fifteen  miles  from  Carson  City.  (For  reference  to  the  mineral 
springs,  see  Climate  of  California.) 

Speings. 

There  is  one  thing  which  California  possesses  in  abundance,  and 
that  is  mineral  springs.  In  a  volume  prepared  by  Dr.  Winslow 
Anderson,  of  San  Francisco,  in  1890,^  the  names  are  given  of  over 
200  California  springs,  with  about  100  analyses.  This  extensive 
list,  however,  does  not  include  all  the  medicinal  springs  known  to- 
day. As  the  work  is  by  far  the  most  complete  one  on  the  subject, 
however,  the  writer  desires  to  express  his  sense  of  obligation  to  it 
for  a  large  part  of  the  information  given  in  the  following  brief  and 
superficial  review. 

Within  the  limits  assigned  it  is  possible  to  refer  to  only  a  few  of 
the  better  known  of  California's  hundreds  of  springs.  For  full 
analyses  reference  must  be  made  to  Dr.  Anderson's  valuable  book. 

Three  miles  from  Ukiah,  the  county-seat  of  Mendocino  County, 
are  the  Doolan  Vichy  Springs.  The  waters  belong  to  the  alkalo- 
carbonated  class,  and  are  clear  and  sparkling  and  of  an  agreeably 
pungent  taste.  They  are  heavily  charged  with  carbonic  acid  gas 
and  carbonates,  and  contain  some  iron  and  potassium  salts.  They 
contain  268  grains  of  total  solids  in  one  gallon,  and  resemble  in 
chemical  composition  the  water  of  Vichy,  France,  and  Ems  and 
Fachingen,  Germany.  The  springs  flow  over  20,000  gallons  per 
hour. 

1  Mineral  Springs  and  Health-resorts  of  California,   etc.     Winslow  Anderson,   M.D.,  San 
Francisco. 


PACIFIC  SLOPE  REGION.  347 

The  famous  Geysers  of  California  are  situated  100  miles  north 
of  San  Francisco,  twenty-six  miles  from  Calistoga,  or  sixteen  miles 
from  Cloverdale.  The  geysers  are  in  a  canon  1700  feet  above  the 
sea.  There  are  dozens  of  springs,  hot  and  warm,  ranging  from 
acid,  alum,  and  iron  to  sulphurous  wells  boiling  at  a  temperature 
of  212°  F. 

Twenty  miles  from  Calistoga,  at  the  base  of  a  spur  of  the  Coast 
Range  of  mountains,  are  the  Harbin  Hot  Sulphurous  and  Saline 
Spring-s.  The  principal  sulphur  spring  flows  1500  gallons  per 
hour  at  a  temperature  of  122°  F.  There  are  also  smaller  chalyb- 
eate, '*  magnesia"  and  ''arsenic"  springs.  At  Harbin  Springs  are 
good  accommodations,  with  line  natural  surroundings. 

Nineteen  miles  from  Calistoga  and  ten  miles  from  the  great  gey- 
sers are  the  Anderson  Mineral  Springs,  comprising  nine  hot  and 
cold  springs,  sulphurous,  saline,  chalybeate,  acid,  and  salino-sul- 
phurous  or  antacid.  The  resort  has  facilities  for  hot  sulphur 
baths,  and  is  in  the  midst  of  attractive  surroundings. 

Twelve  miles  from  Cloverdale  are  the  alkaline  springs  called  the 
California  Seltzer.  The  waters  aie  sparkling  and  carbonated,  and 
contain  187  grains  of  total  solids  in  one  gallon.  There  is  a  com- 
fortable resort  at  the  springs. 

The  Napa  Soda  Springs  are  charmingly  located  on  the  south- 
western slope  of  the  Coast  Range,  at  an  elevation  of  1000  feet. 
They  are  six  miles  from  I^apa  City.  There  are  twenty-seven 
springs  in  all,  with  an  average  daily  flow  of  4000  gallons.  The 
temperature  of  the  water  varies  from  65°  to  68°  F.  Most  of  the 
commercial  Napa  soda  is  obtained  from  the  Pagoda  Spring,  an 
alkalo-chalybeate  water,  strongly  charged  with  carbonic  anhydride, 
delightful,  clear,  and  sparkling,  with  an  agreeably  pungent  taste. 
By  analysis  it  gives  67  grains  of  total  solids  to  one  gallon.  The 
resort  has  a  fine  hotel,  with  beautiful  views  of  Napa  Valley.  It  is 
open  all  the  year. 

In  the  city  of  Calistoga,  and  also  just  outside  the  town,  are 
twenty  or  more  mineral  springs,  ranging  in  temperature  from  75° 
to  186°  F.  They  are  valuable  light  sulphurated  waters,  and  are 
much  used  for  drinking-  and  bathing-purposes. 

Near  the  foot-hills,  in  a  spur  of  the  Coast  Range  of  mountains  in 
Contra  Costa  County,  are  the  Byron  Springs,  sixty-eight  miles 
almost  due  east  of  San  Francisco  and  one  and  one-half  miles 
distant  from  Byron  station.     There  are  over  fifty  springs,  ranging 


348  MEDICAL  CLIMATOLOGY. 

from  52°  to  140°  F.,  from  cold  carbonated  to  hot  sulphurated 
water,  and  located  100  feet  above  the  sea  in  a  small  valley 
or  basin  which  has  the  appearance  of  being  an  extinct  volcanic 
crater.  Only  seven  or  eight  of  the  springs  are  in  active  use. 
They  have  marked  individual  characteristics,  and  form  a  group 
of  great  range  and  value.  Among  them  are  the  ''Black  Sul- 
phur," containing  461  grains  of  total  solids  in  one  gallon  (tem- 
perature, 90°);  the  ''Iron  Spring"  (temperature,  79°),  which  con- 
tains 765  grains  of  total  solids  in  one  gallon — of  which  670  grains 
are  sodium  chloride,  with  nearly  half  a  grain  of  the  peroxide  of 
iron;  the  "Hot  Salt"  alkalo-chlorinated  water,  having  a  tempera- 
ture of  122°  F. — used  for  bathing  ;  and  the  well-named  "  Surprise  " 
Spring,  containing  18,773  grains  of  total  solids  in  one  gallon,  of 
which  15,417  grains  are  sodium  chloride.  This  total  of  over  18,700 
grains  of  mineral  ingredients  is  about  forty  ounces  in  a  gallon,  or 
over  83  per  cent,  held  in  solution,  and  is  more  than  eight  times  as 
dense  as  sea-water.  The  Great  Salt  Lake  (Utah)  contains  four  or 
five  times  as  much  salt  as  the  ocean.  Byron  has  a  hotel  with  con- 
necting cottages,  and  two  large  bath-houses. 

Twelve  miles  west  of  San  Jose,  at  an  elevation  of  1000  feet,  are 
the  Azule  or  Blue  Springs.  The  water  is  carbonated  and  pun- 
gent, and  is  similar  to  the  Seltzer  of  Nassau,  Germany.  It  con- 
tains 261  grains  of  total  solids  in  one  gallon.  Its  action  is  ant- 
acid, aperient,  diuretic,  and  tonic.  It  flows  at  a  temperature  of 
60°  F. 

On  the  eastern  slope  of  the  Coast  Range,  one  hundred  and  fifty 
miles  south  from  San  Francisco  and  seven  miles  south  of  Soledad,  on 
the  Southern  Pacific  Railroad,  are  the  Paraiso  Hot  Springs,  at  an 
elevation  of  1400  feet  above  the  sea.  There  are  several  soda,  iron, 
and  sulphur  springs,  varying  in  temperature  from  100°  to  114°  F. 
The  hotel  aud  cottages  are  of  recent  construction,  and  command  fine 
views  of  the  fertile  valley  of  the  Salinas  River. 

In  the  northern  part  of  San  Luis  Obispo  are  the  Springs  of  El 
Paso  Robles,  a  detailed  description  of  which  will  be  found  on  page 
342. 

In  Santa  Barbara  County  the  hot  springs  north  of  the  town  of 
Santa  Barbara  are  described  on  page  340,  and  those  situated  in  the 
Ojai  Valley,  in  Ventura  County,  on  page  336. 

In  Los  Angeles  County,  thirteen  miles  southeast  from  the  city  of 
Los  Angeles  and  three   miles  north  of  Norwalk  station,  are   the 


PACIFIC  SLOPE  REGION. 


349 


Fulton  Artesian  "Wells,  of  which  the  two  principal  wells  are  350 
feet  deep  and  flow  copiously.  The  waters  contain  a  large  percent- 
age of  iron  salts.     An  analysis  made  by  Dr.  Anderson  follows  : 


Sodium  chloride 
Sodium  bicarbonate  . 
Sodium  sulphate 
Magnesium  bicarbonate 
Ferrous  carbonate 
Calcium  carbonate 
Calcium  sulphate 
Silica 
Organic  matter  . 


(Temperature,  64°.) 


Total  solids 


Grains  in  one  gallon. 

9.60 

2.90 

0.96 
17.45 
11.75 
12.62 
23.41 

2.45 
trace 


81.13 


In  San  Bernardino  County  are  innumerable  thermal  springs,  the 
best  known  probably  being  the  Arrowhead  Hot  Springs,  which  are 
described  on  page  330.  There  are  a  number  of  warm  pools  fed  by 
springs,  between  the  town  of  San  Bernardino  and  the  mountains, 
which  are  used  for  bathing-purposes. 

Palm  Springs.  For  description  of  the  hot  mineral  spring  and 
the  valley,  see  page  332. 

Near  Elsinore,  in  Riverside  County,  is  a  valley  containing  a 
great  number  of  hot  and  cold  springs,  ranging  from  57°  to  212°  F. 
The  cold  springs  are  carbonated,  containing  soda,  magnesia,  and 
iron.  The  hot  waters  are  sulphurous,  with  lime,  magnesia,  and 
borax.  There  are  also  hot  mud-spriug.s.  Unfortunately  this  fine 
resort  is  as  yet  undeveloped. 

.In  front  of  the  village  of  Elsinore  is  the  lake  of  the  same  name, 
six  miles  in  length  and  over  two  miles  in  width.  On  its  shores  are 
orchards  and  ranches,  behind  which  are  the  mountains.  The  eleva- 
tion of  Lake  Elsinore  is  nearly  1300  feet. 

In  San  Diego  County  are  a  number  of  hot  springs,  few  of  which 
are  at  present  available.  Near  Oceanside  is  a  valley  eight  miles 
from  the  ocean,  containing  several  springs,  highly  charged  with  sul- 
phur and  sulphurous  acid,  and  sulphates  of  magnesium,  sodium,  and 
calcium.  The  temperature  of  the  water  ranges  from  85°  to  135°  F. 
They  are  known  as  the  Corral  de  Luz  Hot  Springs. 

In  the  Coahuila  or  Cabezon  Valley,  ten  miles  south  of  White 
River  and  fifty  miles  from  the  city  of  San  Diego,  are  some  hot 


350  MEDICAL  CLIMATOLOGY. 

springs  known  by  the  common  Spanish  name  of  Ag-uas  Calientes. 
These  hot  sulphurous  waters  boil  up  from  a  granite  ledge  on  a  ridge 
at  the  easterly  end  of  Warner's  ranch.  They  range  in  temperature 
from  70°  to  142°  F.  Incrustations  of  crystallized  sulphur  are  de- 
posited on  the  surrounding  rock.  The  waters  have  been  much  used 
for  drinking-  and  bathing-purposes. 

The  Coronado  Spring-  water,  found  on  Coronado  Beach,  is  re- 
ferred to  on  page  320,  and  its  analysis  given. 

The  water  of  Lake  Tahoe,  in  Placer  County,  south  of  Truckee, 
on  the  Central  Pacific  Railroad,  is  remarkably  soft  and  pure,  as  it 
contains  but  three  grains  of  total  solids  in  one  gallon.  The  lake 
is  situated  at  an  altitude  of  6200  feet.  It  is  twenty-one  miles  long 
and  twelve  miles  wide,  and  has  an  average  depth  of  1500  feet. 
From  its  shores  rise  the  snow-elad  peaks  of  the  Sierras.  On  Car- 
nelian  Bay,  at  the  northern  end  of  Lake  Tahoe,  are  the  Oarnelian 
Hot  and  Cold  Mineral  Spring's.  The  waters  are  sulphurous  and 
saline,  and  a  few  are  carbonated.  There  are  bathing-facilities,  and 
tub-,  plunge-,  and  steam-baths  can  be  obtained. 

Near  the  crest  of  the  Sierra  Nevada,  twelve  miles  from  Summit 
Station,  are  the  Summit  Soda  Springs,  which  are  picturesquely 
located  in  a  caiiou,  through  which  winds  one  of  the  forks  of  the 
A  merican  Hiver.  The  elevation  is  6000  feet.  The  water  belongs 
to  the  alkalo-chalybeate  class  and  contains  92  grains  of  total  solids 
to  the  gallon.     It  is  strongly  charged  with  carbonic  acid  gas. 

Channel  Islands  of  California. 

Lying  from  twenty  to  fifty  miles  west  and  south  of  the  main- 
land these  islands  possess  some  well-defined  differences  in  climatic 
features. 

"^A  very  noteworthy  fact  in  their  climatology,  and  one  illustrating 
the  effect  which  the  cold  current  of  the  Kurosiwo  has  upon  the 
northern  coast,  and  which  the  southern  coast  escapes  by  its  deflec- 
tion eastward,  and  through  the  shelter  afforded  by  this  chain  of 
islands,  is  that  the  climate  of  the  outer  tier  of  islands  is  much 
harsher  than  those  nearer  the  mainland.  The  other  islands  are 
nearer  the  current — possibly  within  the  edge  of  that  cold  northern 
stream — while  the  inner  chain  is  surrounded  by  the  flow  of  the 
return  warm  current  from  the  south.  "^ 

The  outermost  islands  are  dry  and  barren.      The  three  largest 

1  California  of  the  South.    J.  P.  Widnev,  M.D. 


PACIFIC  SLOPE  REGION.  351 

islands  are  nearest  the  coast,  and  are  more  fertile.  Tiiey  are  resorted 
to  by  transient  summer-campers  wlio  go  to  enjoy  the  fishing  and 
the  benefits  of  the  ocean-air,  which  is  much  the  same  as  if  one  were 
on  board  a  ship  at  sea.  Dr.  VVidney  says,  if  they  "■  follow  the  gen- 
eral law  of  a  diminishiug  rainfall  as  the  distance  from  the  Sierra  is 
greater,  they  must  have  a  much  less  annual  precipitation  than  the 
mainland.  The  appearance  and  type  of  the  vegetation  and  the 
comparative  scarcity  of  springs  and  ruuning  streams  indicate  the  same 
fact.  They  are  also  much  freer  from  the  strong  sea-breeze  which 
reaches  its  maximum  intensity  near  the  shore  of  the  mainland,  and 
also  from  the  fog  which  forms  along  the  immediate  line  of  the  coast. 

""  They  are  bathed  in  sunshine  when  the  mainland  opposite  is 
enveloped  in  fog.      In  temperature  they  are  more  equable." 

The  principal  island  is  Santa  Catalina,  opposite  the  port  of  San 
Pedro  and  about  nineteen  miles  distant.  The  settlement  on  the  east 
side  of  the  island  is  called  Avelon.  There  are  also  safe  anchorage 
and  landing  on  th^  west  side.  Santa  Catalina  is  about  twenty  miles 
long,  with  an  average  width  of  three  miles.  "It  rises  to  a  height 
of  from  2000  to  3000  feet,  and  is  remarkable  for  the  great  trans- 
verse break  or  depression,  five  miles  from  the  northern  end,  running 
through  it  and  forming  a  cove  or  anchorage  on  each  side.  The  land 
connecting  these  is  very  low,  say  not  over  thirty  feet,  but  the  hills 
rise  up  on  each  side  2000  or  3000  feet,  and  when  sighted  from  the 
north  or  south  the  whole  appears  like  two  very  high  islands. 
There  are  a  number  of  pretty  elevated  valleys,  several  mineral  springs, 
and  wells  of  good  water."^ 

Dr.  T.  J.  MacCarthy,  Professor  of  Chemistry  in  the  Medical  Col- 
lege of  the  University  of  Southern  California,  gives  the  following 
analysis  of  water  from  a  spring  the  most  highly  charged  with  saline 
matters  of  several  examined.  It  is  found  at  an  elevation  of  several 
hundred  feet  : 

Grains  in  one  pint. 
Sodium  chloride  .         .         .         •         .         .         .         .79.5 


Magnesium  chloride 
Magnesium  sulphate    , 
Sodium  sulphate 
Calcium  sulphate 
Magnesium  carbonate 
Iron  and  aluminum     . 


Total  solids 


1  California  of  tlie  SoutJi.    J.  P.  Widney,  M.D. 


21.0 

32.5 

20.5 

6.0 

2.0 

traces 

161.5 


352  MEDICAL  CLIMATOLOGY. 

This  water  he  classes  among  commendable  purgative  mineral- 
waters. 

There  are  on  the  island  a  hotel  and  a  number  of  cottages  and 
boarding-houses.  There  are  many  delightful  spots  for  camping  in 
the  shady  caiion.  The  east  slope  of  the  highest  land,  protected 
from  the  trade-wind,  should  be  as  fine  a  marine  air  as  conld  be 
found.  There  is  good  bathing,  both  surf  and  Stillwater.  A  steamer 
plies  between  San  Pedro  and  Avelon. 

Mr.  Charles  Frederick  Holder,  formerly  editor  of  the  Calfornian, 
who  spent  an  entire  summer  on  Santa  Catalina  Island,  says  it  is  ^'  a 
mountain-range  twenty-two  miles  long  and  from  one  to  eight  miles 
wide,  rising  from  the  ocean  with  grim,  precipitous  walls,  abounding 
in  deep  canons,  and  scenery  grand  and  impressive  beyond  descrip- 
tion.     .      .      .     The  shore,  apparently  of  rock,  rises  abruptly  from 
the  sea,  facing  it  with  a  bold   front,  while  high  above  ridges  and 
peaks  rise  one  behind  the  other — a  maze  of  mountain-ranges.     It 
would  ])uzzle  the  mariner,  were  he   not  familiar  with  the  coast,  to 
find  the  harbor ;  but  suddenly,  as  we  near  the  island,  a  deep  caiion 
is  seen  to  reach   duwn  to  the  sea,  ending  in  a  white  beach;  then 
another,  and,  finally,  a  lofty  sugar-loaf  rock  is  passed,  and  the  little 
half-moon-shaped  bay  comes  in  sight,  with  its  sandy  beach,  its  wide 
caiion  reaching  away  to  distant  mountains,  its  scores  of  picturesque 
cottages  and  homes,  its  white  tents  and  hotels.     The  town  of  Avelon 
is  built  in  the  mouth  of  the  caiion.      .     .      .     The  general  trend  of 
the  island  is  northwest  and  southeast.      The  prevailing  winds  beat 
against  the  south  shore,  while  the  north  is  a  land  of  calms. 
It  was  my  good  fortune  on  a  recent  visit  to  accompany  the  survey 
which  made  a  week's  trip  over  the  various  ranges,  during  which 
many  new  and  interesting   features  of   island-life  were  observed. 
The  upper  portion  of  the  island  is  a  revelation.     Instead 
of  the  sharp  points  of  mountain-peaks,  here  is  a  broad  plateau, 
extending  over  to  the  west  shore,  and  wide  valleys,  suggestive  of 
agricultural  possibilities.      From  a  lofty  point  on  the  west  I  sat 
in  the  saddle  and  tossed  a  pebble  that  must  have  fallen  into  the 
ocean  1500  feet  below.     The  afternoon  breeze  was  blowing  in  the 
mist,  which,  shattered  against  the  wall  of  rock,  drifted  up  the  caiion, 
illumined  by  the  sun,  like  masses  of  molten  silver.     From  far  below 
came  the  roar  of  the  sea  as  it  broke  upon  the  rocks,  the  weird  cry 
of  the  sea-lion,  and  occasionally,  out  from  the  flying  fog,  dashed  a 
white-winged  gull  that  seemed  to  separate  itself  from  the  cloud-mass 


PACIFIC  SLOPE  REGION.  353 

and  become  an  animate  being,  to  eye  me  in  wonderment  and  soar 
away.  The  entire  south  coast  faces  the  sea,  with  forbidding  walls 
of  rock  rising  from  500  to  1500  feet,  breasting  the  sea  with  a  bold- 
front,  hurling  the  masses  of  foam  high  in  the  air,  and  in  the  occa- 
sional winter-storms  forming  a  grand  and  impressive  spectacle. 
Where  the  various  canons  reach  the  sea  are  little  inlets  with  abrupt, 
sandy  beaches,  against  which  the  waves  beat,  and  approachable  only 
on  calm  days.  ...  In  the  centre  of  the  island  the  ocean  was 
not  to  be  seen.  We  might  have  been  a  thousand  miles  from  it,  so 
far  as  any  evidence  of  its  presence  was  concerned.  .  .  .  We 
have  seen  Catalina  in  summer,  with  its  perfect  climate,  always  cool, 
with  that  lack  of  change  so  desirable  to  the  invalid  ;  yet  the  winter, 
if  possible,  is  even  more  delightful.  Then  it  is  that  the  true  beau- 
ties of  this  isle  of  summer  are  seen.  The  rains,  which,  curiously 
enough,  are  less  than  on  the  mainland,  change  the  brown  hills  to  a 
vivid  green,  and  we  have  an  emerald  in  an  azure  setting.  Myriads 
of  flowers  spring  up,  and  the  face  of  the  island  is  changed  as  if  by 
magic.  They  grow  to  the  very  ocean-edge;  their'  delicate  forms 
overhanging  the  water,  and  are  reflected  in  it.  On  the  south  coast, 
where  high  seas  rage  during  the  winter-storms,  the  beds  of  wild 
flowers  are  deluged  by  the  spray  that,  hurled  high  in  the  air,  is 
borne  away  over  the  fields  to  cover  the  delicate  forms  with  gleam- 
ing spangles  of  salt.  The  island  winter  exists  but  in  name.  In 
February  and  through  the  winter  months  Catalina  is  still  an  island 
of  summer."^ 

The  Island  of  Santa  Cruz  is  about  twenty-one  miles  by  four, 
and  lies  twenty  miles  out,  opposite  Santa  Barbara.  There  is  a 
roadstead  on  the  north  side,  at  the  opening  of  a  valley,  where  wood 
and  water  can  be  obtained.  It  is  said  almost  all  kinds  of  grain  and 
fruit  can  be  raised  on  the  island.  It  rises  to  a  height  of  1700  feet. 
There  are  sea-lions  on  the  rocks.  In  the  interior  are  large  flocks 
of  sheep. 

Santa  Rosa  Island  is  five  miles  west  of  Santa  Cruz.  It  is  about 
fifteen  miles  long  and  ten  miles  wide,  rising  to  an  elevation  of  nearly 
1200  feet.  Parts  of  the  island  are  quite  picturesque.  There  are 
numerous  springs  of  water.  It  is  practically  uninhabited,  l>ut  is 
used  as  a  pasture  for  sheep. 

1  An  Isle  of  Summer.    C.  F.  Holder,  In  Californian  Magazine,  December,  1892. 

23 


354  MEDICAL  CLIMATOLOGY. 

The  Climate  of  Oreg-on  and  "Washington. 

The  coasts  of  these  States  are  tempered,  both  summer  and  winter, 
by  the  Pacific  winds.  The  northwest  winds  briug  geatle  rains  and 
mists  which  moderate  the  summer  heat.  Hailstorms  never  occur, 
and  thunderstorms  rarely.  The  winter  is  the  season  of  most  rain, 
but  the  weather  is  mild  aud  there  is  very  little  snow  and  ice.  The 
rainfall  for  the  year  ranges  from  50  inches  on  the  southern  portion 
of  the  Oregon  coast  to  130  inches  on  the  northern  part  of  the  Wash- 
ington coast. 

At  the  Coast  Range,  which  is  composed  of  the  Cascade  Mountains, 
the  precipitation  lessens  to  about  13  inches  for  the  plains  and  22 
inches  on  the  more  elevated  ground.  Along  the  coast  the  summers 
are  pleasant,  the  temperature  seldom  rising  above  80°  F.,  with  cool 
nights.  The  mean  annual  temperature  is  52°.  The  climate  is 
equable,  the  meau  annual  range  being  only  26°. 

To  the  east  of  the  Cascade  Mountains,  however,  the  summers  are 
both  hot  and  dry,  and  the  winters  are  much  more  severe,  resembliug 
those  of  Pennsylvania. 

These  States  can  scarcely  be  considered  to  be  of  great  value  to 
invalids ;  but  offering,  as  they  do  in  the  coast-districts,  the  advan- 
tages of  a  pleasant,  temperate  climate,  like  that  of  England,  though 
milder,  they  are  well  suited  for  those  who  need  what  may  be  termed 
a  negative  climate.  The  chief  cities,  Portland,  Tacoma,  and 
Seattle,  are  handsome,  attractive,  busy  places  with  excellent  accom- 
modations and  resources  of  all  kinds,  while  the  Puget  Sound  dis- 
trict is  an  agreeable  country  for  the  convalescent  or  the  tired  worker 
to  visit.  The  scenery  is  beautiful  aud  the  opportunities  for  sport 
are  many. 


CHAPTEE    XV. 


MEXICO. 


City  of  Mexico  (elevation,  7400  feet;  population,  350,000; 
distance  from  El  Paso,  1224  miles).  From  the  excellent  met- 
eorological record  of  the  Mexican  Government  the  following  par- 
ticulars relating  to  the  climate  of  the  City  of  Mexico  have  been 
obtained  : 

The  dry  season  is  from  November  to  April,  inclusive,  during 
which  period  the  normal  rainfall  (based  on  records  for  fifteen  years) 
is  2^  inches  on  24  rainy  days.  The  other  six  months  have  22  inches, 
falling  on  115  rainy  days.  The  rains  begin  in  April  or  May,  and 
are  greatest  in  June,  July,  August,  and  September.  The  mornings 
as  a  rule  are  clear,  but  heavy  rains  fall  during  the  afternoon  and  at 
night  almost  daily  during  the  rainy  season.  The  normal  annual 
precipitation  is  a  little  over  24  inches  on  139  rainy  days. 

The  annual  mean  temperature  is  60°  F.  The  mercury  in  the 
shade  rarely  goes  above  86°  or  below  35°.  The  daily  range  is,  how- 
ever, considerable,  frequently  30°  or  40°.  The  mean  temperature 
for  winter  is  54°,  with  a  maximum  of  76°  and  a  minimum  of  30°  ; 
for  spring  it  is  63°,  with  a  maximum  of  86°  and  a  miuimum  of  38°. 
The  hottest  months  are  April  and  May,  which  have  a  mean  of  63° 
and  64°  respectively.  The  coldest  months  are  December  and  Janu- 
ary, which    each    average    53°.      February   is    variable,  causing    a 

proverb  : 

"  Febrero  loco 
Porque  de  todo 
Tiene  un  poco," 

which  is  to  the  effect  that  February  is  a  fool,  because  it  has  a  little 
of  everything. 

The  mean  annual  relative  humidity  is  60  per  cent.  Winter  is  56 
per  cent.;  spring,  49  per  cent.;  and  the  remaining  six  months  68 
per  cent.  The  wind-movement  is  very  low,  averaging  for  the  year 
less  than  two  miles  per  hour. 

Humboldt  estimated  the  Plain  of  Anahuac  or  Valley  of  Mexico 


356  MEDICAL  CLIMATOLOGY. 

as  fifty-five  miles  in  length  by  thirty-seven  miles  in  breadth.  Later 
writers  have  slightly  increased  these  dimensions.  It  is  surrounded 
on  all  sides  by  a  wall  of  mountains  which  end  the  view  looking 
down  nearly  every  street  in  the  city.  On  this  plateau  are  five 
lakes,  of  which  the  lowest,  Texcoco,  has  no  outlet  and  is  salt.  The 
near  presence  of  these  large  bodies  of  water  increases  the  dampness 
of  the  city,  which  is  built  but  a  few  feet  above  the  level  of  Lake 
Texcoco,  and  has  added  greatly  to  the  difficulty  of  proper  drainage. 
After  several  centuries  of  temporizing  this  great  problem  has  been 
taken  up  with  more  energy,  and  relief  for  most  of  the  valley  was 
promised  by  the  autumn  of  1895.  To  the  invalid  this  question  of 
drainage  is  of  the  greatest  importance.  "  Beneath  the  pavements  of 
Mexico,"  says  F.  A.  Ober,  "  is  the  accumulated  filth  of  five  hundred 
years."^  The  foundations  of  the  buildings  are  laid  in  marshy  soil,  and 
it  is  but  a  few  figet  down  to  stagnant  water.  During  the  rainy  season 
an  unusually  protracted  downpour  turns  the  streets  into  rivers  of 
mud,  and  the  town  for  a  time  is  almost  uninhabitable.  Malarial 
and  typhus  fevers  are  more  prevalent  than  they  ever  should  be  in 
such  a  healthy  climate.  The  new  system — now  about  completed — 
consists  of  forty  miles  of  canal  and  six  miles  of  tunnel,  cut  through 
the  mountains,  and  flowing  north  into  the  river  Panuco.  Although 
the  completion  of  this  canal  and  tunnel,  by  draining  the  southerly 
portion  of  the  valley  through  its  lowest  lake,  will  be  of  general 
benefit  and  preserve  the  City  of  Mexico  from  future  inundations,  it 
will  still  be  necessary  for  the  sewers  of  the  city  to  be  newly  con- 
structed and  connected  with  this  system  of  drainage — a  work  of 
great  labor  and  expense,  requiring  many  years.  Until  this  has 
been  done  the  drainage  will  remain  inefficient. 

The  Mexican  capital  has  a  delightful  climate — not  quite  so  dry, 
so  far  as  that  factor  is  concerned,  as  some  of  the  cities  near  the 
plains  further  north.  The  moderate  height  of  the  mercury  in 
summer  during  the  rains  is  surprising.  On  the  few  occasions 
when  a  cold  wind  sweeps  down  from  the  north,  the  cold  is  trying 
to  delicate  persons,  on  account  of  the  great  thickness  of  the  stone- 
walls and  the  lack  of  fireplaces  or  stoves.  It  is  more  chilly  indoors 
than  outdoors  at  such  times. 

Mr.  Ober  quotes  the  saying  of  a  French  traveller  that  '' Mexico 
is  a  grand  city  in  the  Spanish  style,  with  an  air  more  inspiring, 

1  Travels  in  Mexico.    P.  A.  Ober. 


MEXICO.  357 

more  majestic,  more  metropolitan  than  any  city  of  Spaiu  except 
Madrid.  Crowned  by  nnmeroiis  towers,  and  surrounded  by  a  vast 
plain  bounded  by  mountains,  Mexico  reminds  one  somewhat  of 
Rome.  Its  long  streets,  broad,  straight,  and  regular,  give  it  an 
appearance  like  Berlin.  It  has  some  resemblance  to  Naples  and 
Turin,  yet  with  a  character  of  its  own.  It  makes  one  think  of 
various  cities  of  Europe,  while  it  differs  from  all  of  them.  It 
recalls  all,  repeats  none." 

The  city  is  well  laid  out,  with  wide  streets  and  avenues  which  are 
adequately  lighted  at  night.  Thi^  principal  streets  are  paved  with 
asphalt,  and  kept  clean.  There  is  an  unusually  large  jj/aza,  on  which 
the  band  plays,  a  beautiful  alarneda,^  and  several  public  gardens. 
The  fashionable  drive  is  on  the  noble  avenue  called  the  Paseo  de  la 
Reforma,  leading  out  to  Chepultapec.  The  view  from  the  towers  of 
the  grand  cathedral  is  very  fine,  although  it  embraces  only  a  por- 
tion of  the  southern  half  of  the  great  valley.  There  are  a  number 
of  good  hotels  and  restaurants,  four  theatres  besides  the  circus,  and 
many  fine  public  aud  business  buildings.  There  are  a  great  many 
magnificent  residences,  always  built  around  a  patio,  containing 
flowers  and  palms  and  fountains.  There  is  an  extensive  system 
of  tram-cars  drawn  by  mules.  French  and  English,  as  well  as 
Spanish,  are  spoken  in  the  hotels  and  shops. 

Guadalajara  (elevation,  5100  feet;  population,  100,000),  one 
hundred  aud  sixty-one  miles  west  of  the  main  line  of  the  Mexican 
Central  Railroad  at  Irapuato,  is  a  beautiful  city,  the  capital  of  the 
State  of  Jalisco,  situated  one  hundred  and  thirty  miles  from  the 
Pacific  Ocean.  It  is  well  laid  out  and  possesses  some  of  the  finest 
public  buildings,  parks,  and  gardens  in  Mexico. 

Guadalajara  is  well  supplied  with  restaurants  and  hotels.  As  in 
the  capital,  the  service  most  satisfactory  to  Americans  is  found  in 
establishments  managed  by  a  French  or  German  proprietor.  The 
cathedral  contains  an  Assumption  ascribed  to  Murillo.  The  Gov- 
ernor's palace  and  the  Degoldado  Theatre  are  large  and  costly  build- 
ings. 

The  drainage  and  general  sanitary  condition  are  superior  to  those 
of  most  Mexican  towns. 

The  climate  is  fine,  although  warmer  than  that  of  the  City 
of    Mexico,   the    average  for  the  year  being  about    8°   higher  for 

1  Alameda  (ar-lar-may'-da).    A  shady  street  or  walk  planted  with  poplars  or  cottonwoods 
(from  alamo,  poplar). 


358 


MEDICAL  CLIMA  TO  LOG  Y. 


Gruadalajara.    The  mean  annual  temperature^is  67°  F.     During  five 
years  the  maximum  was  96°  and  the  minimum  24°. 

The  seasonal  record   for  the  year  1885,  taken  at  12  m.,  was  as 

follows  : 


Temperature. 

Relative 

ViiiTnif^i  tv 

Total 

Mean. 

Max. 

Min. 

11  LiiUlLlitJt  . 

12  m. 

rainfall. 

Winter, 

60° 

82° 

40° 

49  per  ct. 

1.40  in. 

Spring, 

71 

91 

51 

39     " 

2.12  " 

Summer, 

72 

88 

54 

61     " 

23.25  " 

Autumn, 

66 

83 

51 

60     " 

10.64  " 

The  rainfall  from  November  to  April  was  about  2  inches,  leaving 
about  35|  inches  for  the  months  from  May  to  October.  The  heaviest 
precipitation  was  in  June,  July,  Angust,  and  September.  The 
normal  annual  rainfall  for  ten  years  is  34  inches,  and  the  annual 
mean  of  the  relative  humidity  at  noon  53  per  cent.  The  wind- 
movement  is  usually  low.  For  1885  it  barely  reached  the  rate  of 
two  and  one-half  miles  per  hour. 

As  these  observations  in  Guadalajara  were  taken  but  ouce  a  day, 
which  is  unusual,  it  will  be  instructive  to  compare  the  temperature 
and  relative  humidity  with  the  noon-record  of  Colorado  Springs  for 
one  year,  taken  at  the  same  hour  of  the  da}' : 


Colorado  Springs,  Col. 
Latitude  38°  50',  elevation  6000  feet. 


Observations 

Winter 

Spring 

Summer 

Autumn 

Year  . 


for  the  year  1893. 


Mean 

Mean  relative 

temperature. 

humidity. 

12  Ji. 

12  m. 

.      40° 

33  per  ct. 

.     51 

31       " 

.     75 

33       " 

.     58 

27       " 

.     56 

31       " 

To  continue  the  comparison,  the  normal  annual  rainfall  for  Colo- 
rado Springs  is  about  14|^  inches,  of  which  the  five  months  from 
April  to  August,  inclusive,  are  entitled  to  11  inches.  The  winter 
rainfall  (December,  January,  and  February)  at  Colorado  Springs  is 
0.7  of  an  inch,  and  at  Guadalajara  1.4  inches.  There  are  usually 
57  cloudy  days  in  the  year  at  Colorado  Springs  and  126  cloudy  days 
at  Guadalajara.  In  winter,  cloudy  days  at  Colorado  Springs  (four 
years),  13  days  ;  at  Guadalajara  (five  years),  25  days.  Except  in 
the  summer,  it  is  seen  to  be  8°  to  20°  F.  cooler  at  noon  at  the 
springs,  and  the  much  lower  record  of  relative  humidity  shows  a 
drier   climate.       This    humidity-record  for    the    year    at    Colorado 


MEXICO.  359 

Springs,  taken  at  noon,  is  20  per  eeut.  lower  tlian  the  yearly  mean, 
based,  as  is  customary,  on  daily  morning  aud  evening  observations. 

If  this  rule  is  applied  to  the  record  of  Guadalajara,  the  actual 
annual  normal  relative  humidity  will  then  appear  to  be  over  70  per 
cent,,  instead  of  53  per  cent.,  as  shown  by  the  above  noon-observa- 
tions. 

Guadalajara  is  partly  protected  on  the  west  from  the  Pacific 
winds  by  broken  ranges  of  mountains.  There  are  occasional  early 
morning  mists,  and  on  Lake  Chapala  heav^y  mists  are  frequently 
noticed.^ 

Lake  Chapala  is  a  beautiful  sheet  of  water  forty  miles  south  of 
Guadalajara.  It  is  6000  feet  above  the  sea.  Its  length  is  fifty 
miles  and  its  average  width  about  eighteen  miles.  The  northern 
shore  is  well  timbered  and  backed  by  picturesque  hills.  A  steamer 
plies  on  the  lake. 

The  Falls  of  Juanacatlan,  said  to  be  the  next  in  volume  in  North 
America  to  Niagara,  which  they  resemble  in  some  ways,  are  fifteen 
miles  east  of  Guadalajara,  and  can  be  reached  by  tram-car.  The 
river  Lerma,  or  Rio  (yrande  de  Santiago,  is  here  560  feet  wide  and 
falls  sixty-five  feet  in  a  single  leap. 

The  pleasant  suburb  of  San  Pedro,  on  a  ridge  higher  than  the 
city,  is  resorted  to  in  summer  by  the  wealthy  residents. 

A  sanitarium  in  Guadalajara  is  being  carried  on  under  American 
management. 

The  cities  of  Mexico  aud  Guadalajara  were  the  only  ones  for 
which  detailed  weather-observations  could  be  obtained.  Table 
XIII.  contains  the  annual  mean  for  twelve  Mexican  cities. 

A  brief  description  of  many  of  the  more  important  towns  of  Mexico 
follows.  The  elevations  of  most  of  the  principal  cities  were  furnished 
by  the  Government  Weather  Bureau. 

Monterey  (latitude,  25°  40'  north  ;  elevation,  1600  feet ;  popu- 
lation, 30,000),  on  the  Mexican  National  Railroad,  one  hundred 
and  sixty-eight  miles  from  Laredo,  is  situated  in  a  beautiful 
valley,  and  is  much  frequented  as  a  winter-resort,  as  it  has  a 
mild,  although  quite  moist,  climate.  There  are  two  hotels.  The 
annual  rainfall  is  excessive,  amounting  in  some  years  to  124  inches. 
The  mean  annual  temperature  is  70°  F. ;  maximum,  92°;  minimum, 
53°.     Mean  winter-temperature,  55°.     The  prevailing  direction  of 

1  Summerland  Sketches.    Felix  L.  Oswald,  M.D. 


360  MEDICAL  CLIMATOLOGY. 

the  wiud  is  southeast.  Mouterey  is  the  most  Americanized  of  the 
Mexican  towns.  It  is  distant  about  two  hundred  miles  in  a  direct 
line  from  the  Gulf  of  Mexico. 

The  Topo  Chico  Hot  Springs  are  situated  three  miles  east  of 
Monterey.  There  are  tAvo  springs,  one  a  tepid  arsenic  spring,  the 
other  very  hot,  said  to  be  208°  F.      There  is  a  hotel  at  the  springs. 

Saltillo  (latitude,  25°  25'  north  ;  elevation,  5350  feet ;  popula- 
tion, 20,000).  Saltillo  is  about  sixty-five  miles  southwest  of  Mon- 
terey, and  3700  feet  higher,  on  the  northeastern  edge  of  the  great 
Central  Mexican  plateau.  There  is  a  fertile  valley  between  the  two 
tow  us.  The  principal  interests  are  manufacturing  ;  there  are  several 
cotton  aud  woollen  mills.  There  is  but  one  hotel  beside  the  railroad 
restaurant.  The  town  is  regularly  laid  ont,  with  several  plazas  and 
an  alameda.  The  houses  are  built  usually  of  sun-dried  bricks. 
Water  is  brought  from  the  mountain  in  an  aqueduct.  It  is  not  so 
modern  a  town  as  Monterey,  but  is  drier. 

The  baths  of  San  Lorenzo  are  three  miles  from  the  towu. 

Saltillo  has  a  mean  annual  temperature  (from  a  record  for  four 
years)  of  62°  F.;  maximum,  93°;  minimum,  27°.  Mean  annual 
relative  humidity,  61  per  cent.  Mean  annual  absolute  humidity, 
3.75  grains  of  vapor  to  the  cubic  foot.  Mean  annual  precipitation, 
21  inches.  Mean  annual  velocity  of  wind  not  given  ;  prevailing 
direction  north. 

Chihuahua  (elevation,  4700  feet ;  population,  20,000)  is  on 
the  Mexican  Central  Railroad,  two  hundred  and  twenty-five  miles 
south  of  El  Paso.  The  towu  is  situated  on  a  level  plain,  surrounded 
by  hills,  on  the  small  Rio  Chubisca.  The  railroad  station,  as  is 
customary  in  Mexico,  is  one  mile  from  the  town.  Horse-cars  run 
to  the  2^^(^^(^'  The  flat,  Moorish-looking  buildings  are  usually  of 
one  story — sometimes  two,  and  on  some  streets  they  are  built  with 
ari'ades  over  the  sidewalks.  The  fine  cathedral  of  San  Francisco, 
formerly  known  as  the  church  of  La  Parroquia,  faces  the  small 
p/aza,  which  has  some  trees  and  a  fountain.  There  are  also  two 
alainedas  or  tree-shaded  streets — cottonwoods  predominating.  In 
some  cases  these  trees  are  five  feet  in  diameter.  There  are  two 
newspapers,  large  markets,  a  mint,  an  ice-factory,  and  a  flouring-mill. 
The  band  plays  on  the  plaza  three  evenings  a  week.  Not  much 
can  be  said  for  the  hotels.  The  hottest  months  are  from  May  to 
August.  The  rainy  season  is  from  June  to  October.  No  weather- 
record  for  Chihuahua  was  obtainable. 


MEXICO.  361 

There  is  a  town-supply  of  water,  brought  iu  an  old  aqueduct. 
The  country  immediately  around  the  town  is  fertile  and  cultivated, 
there  being  a  number  of  large  ranches  or  haciendas.  Fine  grapes 
are  grown  here.  Chihuahua  is  sufficiently  near  to  the  United  States 
to  have  a  few  ''American  "  methods  and  ideas. 

Durango  (elevation,  6200  feet ;  population,  30,000).^  At  Tor- 
reon,  five  hundred  and  eighteen  miles  from  El  Paso,  passengers  on 
the  Mexican  Central  Railroad  can  take  the  train  on  the  Mexican 
International  Railroad  for  Durango,  one  hundred  and  fifty-seven 
miles  distant  to  the  southwest.  The  journey  requires  about  six 
hours.  Durango  is  situated  in  the  plain  of  San  Antonio,  on  the 
southeast  slope  of  the  mountains,  the  main  range  of  the  Sierra 
Madre  being  about  thirty  miles  west.  The  foot-hills  extend  to  the 
city,  which  is  sheltered  by  the  mountains  from  the  influence  of  the 
prevailing  Pacific  winds.  The  distance  from  the  ocean  is  about  one 
hundred  and  forty  miles  in  an  air-line. 

The  streets  are  regularly  laid  out  and  well  shaded.  The  plazas 
are  attractive,  with  flowers  all  the  year.  The  town  relies  on  sur- 
face-drainage ;  but  the  streets  slope  to  the  south,  and,  as  the  subsoil 
is  sandy,  the  drainage  is  not  particularly  objectionable.  The  water 
is  soft  and  pure  and  the  supply  plentiful.  There  are  thermal  baths 
supplied  from  springs  flowing  in  the  town.  The  usual  rainy  season 
of  the  Cordilleras  prevails  from  June  to  October,  the  heavy  rains 
falling  usually  during  the  afternoon.  The  rainfall  for  the  year, 
June  1,  1894,  to  May  31,  1895,  was  21i  inches,  of  which  1.85 
inches  fell  during  the  seven  months  from  November  to  May,  inclu- 
sive, and  19.75  inches  during  the  five  months  from  June  to  October, 
inclusive.  The  temperature  by  seasons  for  the  same  period  was  as 
follows:  monthly  mean,  winter,  50°  F.;  spring,  67°;  summer,  71°; 
autumn,  61°;  annual,  62°.  The  maximum  temperature  was  88°  in 
May,  and  the  minimum  20°  iu  February. 

Zacatecas  (elevation,  8180  feet ;  population,  50,000),  This 
mining-town  is  picturesquely  crowded  into  a  ravine,  about  half  a 
mile  above  the  level  of  the  surrounding  plain.  A  tramway  leads 
from  the  station  to  the  business-centre — a  ride  of  nearly  half  an 
hour.  There  are  two  plazas,  a  market,  cathedral,  mint.  State  and 
municipal  palaces,  etc.     An  inadequate  supply  of  water  is  brought  in 

1  The  elevation  given  by  the  engineers  of  the  Mexican  International  Railroad  is  6207  feet. 
Humboldt  estimated  the  elevation  of  Durango  at  6840  feet,  and  its  environs  as  averaging  6560 
feet.    The  railroad  officials  estimate  the  population  (ISte)  at  possibly  35,000. 


362  MEDICAL  CLIMATOLOGY. 

by  means  of  an  old  aqueduct  and  then  distributed  from  the  fountains 
or  basins,  into  which  it  trickles,  by  aquadores  or  water-carriers. 
The  streets  are  poorly  paved  and  badly  drained.  The  buildings  are 
usually  built  of  stone,  and  are  two  or  three  stories  in  height.  One 
of  the  hotels  (the  ''Zacatecano")  occupies  a  portion  of  what  was 
formerly  the  Convent  de  Agustinos.  Zacat^cas  is  situated  in  an 
arid  region,  which,  with  its  elevation  of  a  mile  and  a  half  above 
the  sea,  accounts  for  its  cool  and  dry  climate.  The  silver  mines 
are  ^within  convenient  distance  for  visitors. 

The  mean  monthly  temperature  at  Zacatecas  for  1894,  by  seasons, 
was  as  follows  :  winter,  55°  F.;  spring,  64°;  summer,  64°;  autumn, 
59°;  annual,  61°;  mean  for  January,  54°;  for  May,  70°;  for  July, 
62°.  ^    ^  ^  ' 

Guadalupe,  a  suburb  six  miles  distant  from  Zacatecas  and  at  a 
lower  elevation,  is  reached  by  tram-cars.  The  town,  although 
small,  has  a  grand  old  church,  with  chapel,  cloisters,  and  garden, 
an  orphan  asylum,  a  picturesque  market,  aiid  some  fine  private 
gardens. 

Aguas  Calientes  (elevation,  6100  feet ;  population,  35,000). 
An  attractive  but  ''slow"  and  quiet  city,  built  on  a  fertile  plain, 
which  is  highly  cultivated.  The  usual  tramway  runs  from  the 
railroad  station.  The  hot  springs  are  two  miles  east  of  the  town 
and  one  mile  east  of  the  station,  at  the  end  of  a  beautiful  alameda. 
The  bath-houses  are  of  stone,  and  contain  large  pools  of  warm 
water  (about  96°  F.).  There  are  three  groups  of  bath-houses,  Los 
Bancs  Chicos  having  the  prettiest  surroundings.  The  natives 
bathe  publicly  in  the  tree-shaded  canal  that  flows  by  the  side  of 
the  Paseo. 

Aguas  Calientes  ^has  several  plazas  and  many  beautiful  gardens. 
The  band  plays  in  the  principal  plaza  two  or  three  times  a  week. 
The  hotels  are  good.  There  is  a  market,  and  fruit  is  abundant  and 
cheap. 

Aguas  Calientes  is  half  a  day's  railroad  journey  from  Zacatecas, 
and  being  2000  feet  lower  has  a  more  balmy  and  less  chilly  air  than 
the  mining-town. 

The  raean'fmonthly  temperature  for  1894,  by  seasons,  was  as  fol- 
lows :  winter,  57°  F.  ;  spring,  67°;  summer,  71°;  autumn,  64°; 
annual,  65°;  mean  for  January,  55°;  for  May,  74°;  for  July,  71°. 

San  Luis  Potosi'  (elevation,  6200  feet ;  population,  60,000)  is 
situated  on  a  branch  of  the  iSIexicau  Central  Railwav  runniuo;  to 


MEXICO.  363 

Tainpico,  and  is  one  huudred  and  thirty-nine  miles  from  Aguas 
Calientes.  It  is  also  on  the  main  line  of  the  Mexican  National 
Railroad.  It  is  a  busy,  progressive  city,  owing  much  of  its  impor- 
tance to  the  silver-mines  in  the  vicinity.  It  is  surrounded  by  a  broad 
and  fertile  plain,  and,  being  about  two  hundred  miles  from  the  Gulf 
of  Mexico,  is  protected  from  moist  winds  by  ranges  of  mountains  to 
the  east  and  south.  San  Luis  Potosi  has  clean  streets  that  are  regu- 
larly laid  out  and  well  paved.  The  drainage  is  poor,  but  not  dan- 
gerous. There  is  an  imposing  cathedral,  several  handsome  j3/a5:as, 
and  a  spacious  alameda.  The  garrison  military  band  plays  three 
evenings  a  week.  .  The  churches  and  public  edifices  are  built  of 
stone,  adorned  with  carving.  Most  of  the  buildings  are  two  stories 
in  height.  There  are  electric  lights  and  tram-cars.  The  railroad 
station  is  near  the  centre  of  the  city. 

San  Luis  Potosi  has  a  fine  climate,  with  a  moderate  yearly  rain- 
fall. The  mean  monthly  temperature  for  1894,  by  seasons,  was  as 
follows:  winter,  57°  F.;  spring,  68°;  summer,  69°;  autumn,  62°; 
annual,  63°;  mean  for  January,  57°;  for  May,  72°;  for  July,  68°. 

Leon  (elevation,  5900  feet ;  population,  100,000).  Leon  is  a 
manufacturing  city  in  the  centre  of  a  rich  valley,  where  there  are 
farms  and  grazing-lands.  The  streets  are  narrow,  with  workshops 
on  every  block.  The  principal  objects  of  interest  are  the  main 
plaza,  the  paseo — which  is  a  part  of  the  highway  to  Silao — the 
cathedral,  and  a  fine  theatre.  The  water-supply  is  abundant.  A 
tramway  runs  from  the  railroad  station  to  the  centre  of  the  city. 
In  1894  the  mean  monthly  temperature  was  for  winter,  58°  F.;  for 
spring,  69°;  the  hottest  month  (May)  having  an  average  of  74°. 

Silao  (elevation,  5900  feet;  population,  15,000),  situated  twenty 
miles  south  of  Leon,  is  an  attractive  town  with  several  fine  churches 
and  many  handsome  gardens.  Twenty  miles  south  of  Silao  is  Ira- 
puato,  a  town  of  14,000  inhabitants,  noted  for  its  strawberries. 
The  railroad  station  is,  as  usual,  a  mile  away  from  the  town. 
Mean  annual  temperature  for  Silao  for  1894  was  66°  F. ;  for  the 
winter  months,  59°;  spring,  69°.      May  averaged  75°. 

Guanajuato  (elevation,  6750  feet;  population,  50,000),  fifteen 
miles  northeast  from  Silao,  is  reached  by  a  branch  road,  the  last 
three  or  four  miles  being  tramway.  Guanajuato  is  a  mining-town, 
situated  in  a  narrow  ravine,  which  has  been  terraced  on  each  side  to 
afiford  room  for  building.  The  streets  are  narrow  and  steep  and  are 
frequently  only  stairways  from  one  terrace  to  another.     It  is  a  quaint 


364  MEDICAL  CLIMATOLOGY. 

and  interesting  old  place,  with  costly  churches,  a  mint,  and  a  fine 
theatre.  There  are  also,  in  spite  of  the  steep  hillsides,  a  pretty 
little  p/ftsa  and  an  alameda.  Guanajuato  is  picturesque,  but  unsani- 
tary. Its  open  drains  are  unhealthy,  and  it  is  a  draughty  place  for 
invalids. 

The  mean  annual  temperature  is  63°  F.,  with  a  range  during  the 
year  from  34°  to  87°.  In  1894  the  mean  temperature  for  January 
was  57°;  for  winter,  59°;  spring,  67°.  The  mean  annual  relative 
humidity  is  58  per  cent,  and  the  mean  annual  rainfall  38  inches. 

Near  Guanajuato  is  the  famous  Valenciana  silver-mine,  with  its 
village  and  splendid  church. 

Queretaro  (elevation,  6060  feet ;  population,  50,000)  is  a  beau- 
tiful city  on  a  smiling  plain,  encircled  by  distant  mountains.  The 
climate  of  Queretaro  is  considered  very  fine.  The  streets  are  nar- 
row and  winding,  but  usually  clean.  There  are  several  plazas  with 
palms,  shrubs,  roses,  and  luxuriant  vegetation,  and  a  beautiful  ala- 
meda  with  great  trees.  Water  is  conveyed  from  a  stream  five  miles 
distant  by  means  of  a  stone  aqueduct  architecturally  impressive. 
There  are  a  number  of  public  fountains.  In  addition  to  the  cathedral 
of  San  Francisco,  recently  ''restored,"  there  are  several  fine  old 
churches,  and  the  constant  ringing  of  bells  is  noticeable,  even  for 
Mexico.  Near  the  city  is  the  melancholy  Hill  of  the  Bells,  where 
Maximilian  and  two  of  his  generals  were  shot,  June  19,  1867.  In 
1894  the  seasonal  temperature  in  Queretaro  was  as  follows  :  winter, 
59°  F. ;  spring,  69°;  summer,  68°;  autumn,  62°.  The  monthly 
mean  for  January  was  60°;  and  iov  May  (the  warmest  month)  72°; 
for  July,  67°;  annual  mean,  65°. 

Pachuca  (elevation,  8070  feet ;  population,  30,000)  is  forty-four 
miles  east  of  Tula  and  is  reached  by  a  branch  from  the  main  line  of 
the  Mexican  Central  Railway.  Pachuca  has  about  the  same  elevation 
as  Zacatecas  and  a  similar  climate,  although  situated  two  and  one- 
half  degrees  further  south.  The  town  lies  in  a  basin  surrounded  by 
mountains,  and  is  in  the  centre  of  a  rich  silver-mining  district.  The 
streets  are  steep  and  narrow. 

As  in  the  country  east  of  San  Luis  Potosi,  a  sharp  change  of 
climate  can  be  effected  by  going  to  the  eastern  slopes  of  the  moun- 
tains, which  are  kept  fresh  and  green  by  the  moist  air  coming  from 
the  Gulf  of  Mexico.  In  1894  the  mean  monthly  temperature  fiar 
Pachuca  for  January  was  54°  F.;  for  July,  67°;  for  the  year,  59°. 
By  seasons:  winter,  56°;  spring,  60°;  summer,  63°;  autumn,  58°. 


MEXICO.  365 

Puebla  (elevation,  7100  feet;  population,  80,000)  is  distant  from 
City  of  Mexico  one  hundred  and  fifteen  miles  by  rail.  Puebla  is  one  of 
the  cleanest  and  best-drained  cities  in  Mexico.  It  is  a  city  of  churches, 
with  broad  streets,  a  well-kept  main  plaza,  and  no  offensive  smells. 
There  are  other  small  plazas  and  two  paseos.  The  grand  cathedral 
is  second  only  to  that  of  the  City  of  Mexico  in  size,  and  its  interior 
is  more  richly  decorated.  From  the  hill  of  Guadalupe  a  fine  view 
is  obtained  of  the  city  and  its  rich  and  fertile  plain. 
,  Puebla  has  cooler  evenings  and  nights  than  the  capital,  owing  to 
the  closer  proximity  of  the  snow-covered  mountain-peaks. 

The  Pyramid  of  Cholula  is  seven  miles  from  Puebla  to  the  west, 
and  can  be  reached  by  tram-cars. 

Toluca  (elevation,  8650  feet;  population,  20,000).  A  charm- 
ing town  forty-six  miles  west  of  the  City  of  Mexico,  in  a  fertile  val- 
ley surrounded  by  lofty  mountains.  Toluca  has  clean  streets,  an 
alameda,  aod  market  containing  all  the  fruits  of  the  tropical  country 
below.  The  hotels  have  patios  filled  with  flowers.  Baths  are 
usually  attached  to  the  hotels.  The  town  is  provided  with  two 
theatres  and  a  line  of  horse-cars.  The  climate  of  Toluca  is  cooler 
than  that  of  the  City  of  Mexico.  About  forty  miles  from  the  capi- 
tal, where  the  railroad  crosses  the  Sierra  de  las  Cruces,  an  elevation 
of  10,550  feet  is  reached  on  the  Continental  Divide. 

Morelia  (elevation,  6200  feet ;  population,  25,000),  lying  nearly 
two  hundred  miles  west  of  Mexico,  on  the  Mexican  National 
Railroad,  is  one  of  the  prettiest  cities  in  the  republic,  with  an  im- 
pressive cathedral,  a  beautiful  plaza,  where  the  Eighth  Regiment 
band  plays  three  times  a  week,  a  shady  paseo,  and  the  inevitable 
alameda.  The  many  fine  residences  contain  patios,  or  inner  courts, 
with  fountains  and  a  luxuriant  wealth  of  flowers.  The  water  fur- 
nished for  domestic  use  is  muddy.  The  town  lies  in  a  basin  on  the 
western  slope,  surrounded  by  mountains,  and  has  a  softer,  damper 
climate  than  the  cities  on  the  great  inland  plateau,  owing  to  the 
Pacific-influence. 

No  detailed  meteorological  data  were  obtainable. 

Patzcuaro  (elevation,  7000  feet ;  population,  10,000)  is  thirty- 
seven  miles  west  of  Morelia,  situated  on  Lake  Patzcuaro,  which  is 
about  thirteen  miles  long  and  thirty  miles  in  circumference.  This 
Moorish-looking  town  is  two  miles  from  the  station,  and  is  perched 
on  the  hillsides,  whence  extensive  views  may  be  obtained  of  the 
lovely  lake,  with  its  forest-clad  islands,  and  of  the  surrounding 


366  MEDICAL  CLIMATOLOGY. 

mountains.  It  is  a  quaint  town,  with  narrow,  crooked  streets  and 
many  shrines,  and  a  sleepy,  tree-shaded  plaza. 

Across  the  lake,  which  Humboldt  compared  to  Lake  Geneva  in 
beauty,  is  the  Indian  village  of  Tzintzuntzan,  where  there  is  a  ven- 
erable church  containing  a  famous  picture  by  Titian,  called  "■  The 
Entombment,"     A  steamboat  plies  on  the  lake. 

There  are  hot  springs  in  the  neighborhood  of  Patzcuaro,  flowing 
at  a  temperature  of  100°  F. 

The  annual  rainfall  is  more  than  40  inches. 

Orizaba  (elevation,  4090  feet;  population,  15,000).  Orizaba 
lies  on  the  eastern  slope,  within  the  Gulf-influence.  It  is  on  the 
verge  of  the  Tlerra  Caliente,  or  ''hot  lands,"  and  is  supplied  with 
an  abundance  of  fresh  fruit.  The  red-tiled  town  is  finely  situated 
in  a  valley  surrounded  by  mountains.  It  is  a  favorite  winter-  and 
summer-resort.  The  name  is  said  to  mean  ''joy  in  the  water,"  the 
presence  of  which  is  indicated  by  numerous  cascades  within  view. 
The  climate  is  very  good,  except  that  it  is  damp  and  somewhat 
warm.  During  February,  March,  and  April  Orizaba  is  visited 
almost  nightly  by  violent  wind-storms  from  the  mountains.' 

Jalapa  (elevation,  4335  feet;  population,  18,000).  A  quaint 
and  very  old  town  in  a  green  valley,  swept  by  mists  from  the  Gulf. 
Jalapa  is  in  the  coffee-raising  district.  It  has  a  delightful  but  ex- 
ceedingly humid  climate,  as  it  lies  within  the  belt  of  100  inches 
annual  rainfall. 

1  Face  to  Face  with  the  Mexicans.    Mrs.  F.  C.  Gooch. 


PLATE    VIII. 


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17 


RELIEF  MAP  OF  SOUTH  AMERICA! 


From  BUTLEK's  GEOGRAPHIES,  by  i)ermission  of  e.  h.  butlek  a  co.    Copyright, 


CHAPTER    XVI. 

SOUTH   AMERICA. 

The  general  climate  of  South  America  is  chiefly  determined  by 
two  facts  :  first,  the  latitude,  three-quarters  of  the  continent  lying 
in  the  tropical  zone;  and,  secondly,  the  position  and  height  of  the 
Andes  Mountains,  which  run  parallel  to  the  western  coast.  Within 
the  tropics,  as  has  been  said  before,  the  prevailing  winds,  the  "  trades," 
blow  from  the  east,  and  bring  with  them  a  great  amount  of  moisture. 
The  eastern  elevations  are  not  high  enough  to  obstruct  entirely  the 
passage  of  these  winds,  and,  although  some  of  their  moisture  is  pre- 
cipitated here,  they  carry  the  remaining  portion  witii  them,  distrib- 
uting it  over  the  interior  uutil,  being  finally  brought  into  contact 
with  the  high  peaks  of  the  Andes  range,  it  is  condensed  and  falls  in 
showers  on  their  eastern  slopes.  The  western  coast,  being  thus  shut 
off  from  the  moisture-bearing  winds  by  the  extreme  height  of  this 
range,  receives  very  little  rain  and  remains  dry  until  a  latitude  of 
thirty  degrees  south  is  reached.  Here,  however,  the  conditions  change. 
The  prevailing  winds,  being  westerly,  carry  their  moisture  but  a  short 
distance  into  the  interior,  when  they  are  intercepted  by  the  Andes, 
through  whose  cooling  influence  the  aqueous  vapor  is  condensed  and 
precipitated,  this  time  on  the  western  declivities.  The  country  to  the 
eastward  of  these  mountains,  below  the  thirtieth  parallel  south,  is, 
therefore,  dependent  for  its  rainfall  mainly  upon  the  occasional  At- 
lantic winds. 

The  Amazon,  the  monster  river  flowing  through  the  northern 
part  of  this  continent  from  west  to  east,  discharges,  according  to 
the  Encyclopaedia  Britannica,  more  water  than  the  eight  principal 
rivers  of  Asia,  and  the  La  Plata  more  than  all  the  rivers  of  Africa  ; 
and  these  rivers,  the  Amazon  especially,  form  practicable  waterways 
far  into  the  interior  of  the  continent. 

Near  the  equator  the  humidity  of  the  atmosphere  is  so  great  that, 
although  150  inches  of  rain  may  have  fallen  on  the  east  coast,  the 
air  still  retains  sufficient  moisture  to  keep  the  interior,  as  far  as  the 
Andes,  well  watered.     At  Rio  Janeiro  the  mean  yearly  temperature 


368  MEDICAL  CLIMATOLOGY. 

is  about  74°  F.,  and  in  the  district  where  the  Paraguay  takes  its  rise 
it  is  about  65°.  Lima  (540  feet  elevation)  has  a  mean  of  72°,  and 
at  Buenos  Ayres  the  mean  is  68°. 

The  northern  part  of  the  continent  is  covered  with  enormous 
forests. 

The  tropical  character  of  the  seacoast  and  lowlands  is  so  marked 
that  they  are  not  available  for  invalids.  On  the  slopes  of  certain 
portions  of  the  Andes,  however,  are  climates  which  commend  them- 
selves, and  have  under  certain  conditions  been  successfully  used  by 
the  foreign  health-seeker.  It  was  on  this  continent  that  the  alti- 
tude-cure was  first  employed. 

All  these  Andean  health-stations,  except  Arequipa,  have  almost 
insuperable  objections  for  a  great  invalid.  The  long  sea-voyage,  the 
heat  and  discomfort  of  the  coast-towns,  the  inaccessibility  of  the 
mountain-resorts,  necessitating  long  and  fatiguing  journeys  of  per- 
haps two  weeks  on  muleback,  with  the  danger  of  exertion  at  great 
altitudes;  the  trying  heats  and  long  and  severe  rains;  the  annoy- 
ance and  trials  of  bugs,  beetles,  and  all  the  abounding  insect-life  of 
tropical  regions ;  the  unsanitary  conditions  and  utter  lack  of  con- 
veniences and  accommodations  and  of  necessary  supplies ;  the  diffi- 
culty of  always  finding  an  abundant  supply  of  pure,  soft  water; 
together  with  the  experience  of  Spanish  food  and  cooking,  are  cer- 
tainly sufficient  cause  for  Dr. Williams's  conclusion  that  "the  Andes 
can  only  be  considered  a  fit  resort  for  energetic  young  men  with 
limited  tubercular  lesions,  capable  of  enduring  fatigue  and  able  to 
accommodate  themselves  to  conditions  of  life  unlike  those  to  which 
they  are  accustomed." 

The  Andes. 

Portions  of  these  magnificent  mountains  in  the  countries  of  Ecua- 
dor and  Peru  have  long  been  noted  for  their  peculiar  climatic  advan- 
tages of  warmth  and  equability,  with  rarefaction,  caused  by  great 
elevation  being  obtained  in  the  tropical  zone.  These  advantages 
are,  however,  more  apparent  than  real,  as  is  shown  by  careful  inves- 
tigation. 

In  Ecuador  the  Pacific  watershed  receives  rain  copiously  during 
the  winter  and  spring  season,  and  in  many  valleys  and  plains  the 
country  is  fertile.  North  of  latitude  40°  south  the  rains  become 
more  frequent  and  profuse,  and  in  most  of  the  United  States  of 
Colombia  the  vegetation  is  scarcely  inferior  to  that  of  the  Amazon. 


SOUTH  AMERICA.  369 

Further  south,  along  the  coast  of  Peru,  the  moist  Atlantic  currents 
deposit  their  moisture  on  the  eastern  side  of  the  Cordilleras.^  On 
the  Peruvian  coast  while  the  prevailing  cool  south  winds  are  blow- 
ing rain  never  falls.  The  houses  are  built  with  flat  roofs.  Except 
for  scant  verdure  within  the  fog-regions  on  the  hills,  animal-  and 
plant-life  exists  only  where  an  occasional  river,  tied  by  the  snow- 
mountains,  reaches  the  coast.  During  the  colder  months,  between 
April  and  October,  the  winds  are  variable,  partly  blowing  from  the 
north ;  and  from  the  sea  upward  to  an  elevation  of  3000  or  3500 
feet  dense  fogs  prevail,  which  pass  into  misty  rains.^  The  mean 
annual  rainfall  of  Lima  is  9  inches,  while  over  a  large  part  of  the 
arid  plains  of  interior  Peru  it  is  practically  nil. 

The  traveller,  Frank  Vincent,  refers  to  the  climate  of  Lima  as 
bad,  with  five  months  of  rain  and  snow  and  the  rest  of  the  year  hot 
and  dry.^  Another  traveller*  says  Lima  is  very  unhealthy,  with  fog 
and  dampness  for  weeks  in  winter.  The  mean  temperature  during  the 
cold  season,  from  June  into  November,  is  56°  F.  Between  Novem- 
ber and  May  the  maximum  is  82°.  Back  from  the  coast,  within  a 
limited  range,  a  variety  of  climates  can  be  found,  and  fruits  of  the 
tropical  and  temperate  regions  are  to  be  seen  in  the  same  market. 
As  Williams  puts  it :  extensive  plains  exist  at  high  elevations,  on 
which  populous  cities  are  built,  and  in  some  of  these  the  climate 
is  temperate  and  genial.'* 

Bogota,  the  capital  of  the  L^nited  States  of  Colombia,  is  8665 
feet  above  the  sea,  in  latitude  4°  6'  north.  It  is  said  to  have  a 
climate  like  Malaga  and  an  annual  mean  temperature  of  59°  F., 
with  but  little  variation  for  the  different  seasons.  One  writer  gives 
it  a  range  of  55°  to  70°.  The  city  is  situated  in  a  finely  fertile 
country.  It  lies  on  the  eastern  edge  of  a  great  plain  or  valley 
below  two  hills,  called  Guadaloupe  and  Monseratte,  which  rise  1800 
feet  and  1500  feet,  respectively,  above  the  plain.  The  capital  has 
a  population  of  about  100,000,  but  is  isolated  and  difficult  of  access.^ 
It  is  700  or  800  miles  inland  from  the  coast,  and  ten  or  twelve  days 
or  more  are  required  for  the  journey — partly  by  boat  up  the  Mag- 

1  The  Inter-continental  Railway.    W.  D.  Kelley,  in  Cosmopolitan  Magazine,  August,  1893. 
-  American  Resorts,  with  Notes  upon  their  Climate.    Bushrod  W.  James.    Chapter  trans- 
planted from  Dr.  A.  Woeikof  s  Die  Klimate  de  Erde." 
3  Round  and  About  South  America.    Frank  Vincent. 
*  Peru.    E.  G.  Squier. 

5  Aerotherapeutics.    Charles  Theodore  Williams. 

6  The  Capitals  of  Spanish  America.    W .  E.  Curtis. 

24 


370  MEDICAL  CLIMATOLOGY. 

dalena  Kiver  aud  partly  by  muleback  from  Honda  over  wretched 
roads.'  The  city  is  well  built  in  the  Spanish  fashion,  with  streets 
at  right-angles.  Most  of  them  are  poorly  paved.  In  the  business 
section  the  houses  are  usually  two  stories  in  height.  The  dwelling- 
houses  are  built  of  sun-dried  bricks,  whitewashed,  and  are  usually 
one  story  only,  on  account  of  earthquakes.  There  are  said  to  be 
three  months  of  fair  weather,  alternating  with  three  mouths  of  in- 
tense tropical  rains — the  rainiest  season  being  in  the  winter.  The 
records  of  rainfall  and  humidity  of  Bogota  were  not  obtainable. 
The  town  has  a  line  of  telegraph  to  the  outer  world. 

Quito  (elevation,  9350  feet;  population,  40,000),  one  hundred  and 
fifty  miles  (air-line)  north  northeast  from  the  port  of  Guayaquil,  is 
the  capital  of  Ecuador  ;  it  is  situated  in  a  basin  fourteen  miles  south 
of  the  equator,  on  the  eastern  skirts  of  the  volcano  of  Pichincha 
(15,924  feet),  yet  not  in  full  view  of  the  crater  on  account  of  an 
intervening  hill. 

The  climate  is  said  by  Mr.  F.  Hassaurek,  formerly  United  States 
Minister  to  Ecuador,  to  resemble  perpetual  autumn,-  being  fairly 
cool,  with  a  mean  annual  and  seasonal  temperature  of  59°  F.  or  less. 
Crops  do  not  await  the  succession  of  the  seasons ;  flowers  and  leaves 
fall  while  fresh  ones  bud  into  life.  Roses  and  wildflowers  bloom 
all  the  year.  It  is  a  pilgrimage  of  270  miles  from  Guayaquil,  of 
which  seventy  miles  can  be  done  by  steamer  and  rail  and  the  re- 
maining 200  miles  on  mules,  requiring  ten  days  for  the  journey  for 
able-bodied  men.  The  mule-trail  is  called  "el  camino  real,"  and 
has  been  the  highway  of  commerce  for  three  hundred  years.  There  is 
a  telegraph-line  to  the  coast.  Quito  is  much  higher  at  the  north  end 
of  the  town.  It  has  no  proper  water-supply.  The  streets  and  side- 
walks are  narrow  and  indescribably  filthy.  Few  streets  are  paved, 
and  they  are  cleaned  only  by  the  violent  rains  which  prevail  in  the 
afternoons  and  nights  during  the  rainy  season.  The  dry  season  is 
from  June  to  December,  although  it  may  begin  to  rain  in  October  or 
November.  In  January  the  rains  are  frequent  and  descend  with  great 
force.  There  are  no  hotels.  Furnished  houses  of  nine  or  ten  rooms 
can  be  hired  for  from  .$20  to  S40  per  month.  There  are  no  fireplaces, 
or  even  chimneys,  and  few  carts  or  wheeled  vehicles.  The  build- 
ings are  flat  and  heavy  in  appearance,  with  projecting  roofs  to  afford 
protection  against  the  severe  rains.     Travellers  complain  of  feeling 

1  Round  and  About  South  America.    Frank  Vincent. 
■-  Four  Years  Among  Spanish  Americans.    F.  Hassaurek. 


SOUTH  AMERICA. 


371 


cliilly  in  Quito,  and  of  being  troubled  with  cold  feet.  The  changes 
from  midday  to  night  are  sharply  felt,  and  throat-  and  luug-troubles 
are  said  to  be  prevalent.  This  evidently  does  not  refer  to  consump- 
tion. Overcoats  are  worn  in  the  evenings,  and  woollen  socks  are 
advised.  The  temperature  is  said  rarely  to  go  above  90°  F.  or  below 
40°.  It  is  usually  70°  or  75°  during  the  day  and  60°  or  65°  at 
night. 

Mr.  Whymper  quotes  from  a  bulletin  of  the  observatory  at  Quito 
a  table  of  monthly  mean  maxima  and  minima  for  a  complete  year, 
as  follows  :^ 


December, 

1879 

January, 

1880 

February, 

1880 

March, 

1880 

April, 

1880 

May, 

1880 

June, 

1880 

July, 

1880 

August, 

1880 

September, 

1880 

October, 

1880 

November, 

1880 

Max. 

Min 

69° 

41= 

74 

45 

75 

45 

73 

42 

72 

45 

72 

46 

73 

43 

73 

44 

73 

38: 

74 

39 

68 

42 

68 

41 

The  annual  mean  of  the  maxima  was  72°  F.  and  of  the  minima 
42°,  with  a  monthly  mean  temperature  for  the  year  of  57°.  The 
highest  maximum  was  in  February  and  the  lowest  minimum  in 
August,  with  a  rano-e  between  them  of  37°.  The  mean  annual 
rainfall  is  70  inches.  There  does  not  appear  to  be  a  record  of  the 
humidity,  but  from  the  equability  of  temperature  it  is  safe  to  say 
that  it  is  moist.  At  greater  mountain-heights  in  the  interior  of 
Ecuador  the  sun  is  usually  obscured  by  clouds  or  fog,  except  for  a 
short  time  at  midday.  December  and  January  are  usually  warmer 
than  June  and  July. 

Mr.  Whymper's  experience  in  the  Andes  with  ''mountain-sick- 
ness" differed  somewhat  from  that  of  the  engineers  in  charge  of  the 
recent  survey  for  the  Trans-continental  Railway,  who  found  that 
the  fatigue  of  exertion  in  the  rarefied  atmosphere  of  these  high  alti- 
tudes began  to  show  itself  at  8000  or  9000  feet  above  sea-level, 
and  at  14,000  feet  was  apt  to  take  a  form  of  sickness  called  there 


1  Travels  Among  the  Great  Andes  of  the  Equator.    E.  Whymper. 


372  MEDICAL  CLIMATOLOGY. 

'' sorojchi,"^  with  dizziness,  bleeding  at  the  nose  and  ears,  and  per- 
haps bowel-troubles.  Mr.  Whymper  was  not  affected  by  the  sick- 
ness at  the  greatest  heights,  but  at  16,600  feet  suffered  from  intense 
headache  and  weakness,  with  labored  respiration  and  a  geueral  feel- 
ing of  illness.     He  did  not  suffer  from  nausea,  but  had  no  appetite. 

Arequipa  (elevation,  7650  feet)  is  in  latitude  16°  22'  south,  about 
eighty  miles  direct,  or  one  hundred  and  seven  miles  by  rail,  inland 
from  its  port,  Mollendo,  on  the  Pacific.  On  account  of  the  steep 
grades  the  time  required  is  nine  hours.  It  is  the  third  city  in  im- 
portance in  Peru,  with  a  population  of  35,000,  largely  Indians,  and 
is  on  the  line  of  railway  from  the  coast  to  Lake  Titicaca. 

The  city — which  is  known  as  the  "Gem  of  the  Andes" — is  well 
situated  on  a  green  and  irrigated  sandy  plain,  through  which  flows 
the  river  Chile.  There  are  few  trees  except  eucalypti.  The  houses 
are  usually  of  one  story,  built  of  a  white  stone  of  volcanic  origin, 
called  ''sillar."  The  streets  are  narrow,  and  partly  paved  with  cob- 
blestones. There  are  tram-cars,  fair  hotels,  and  a  club.  Many  of  the 
churches  are  several  centuries  old  and  covered  with  quaint  carvings, 
but  the  greater  part  of  the  town  is  rebuilt  on  the  ruins  of  the  great 
earthquake  of  1868.  The  Harvard  College  observatory,  which  has 
an  establishment  near  Arequipa,  on  a  hill  400  feet  above  the  town, 
has  also  erected  a  meteorological  station  on  the  summit  of  the  neigh- 
boring volcano.  El  Misti,  at  the  great  height  of  19,300  feet  above 
the  sea. 

Although  noted  for  its  delightful  climate,  the  heat  in  Arequipa  is 
said  by  Mr.  Vincent  to  be  intense.^  Professor  Pickering,  of  the 
Harvard  Astronomical  Observatory,  on  the  contrary,  in  a  brief  mete- 
orological summary  for  the  year  1891  (published  in  Astronomy  and 
Astro-Physics,  May,  1892^),  states  that  the  hottest  day  was  June  3d, 
when  the  thermometer  rose  to  79°  F.,  and  the  coldest  was  eight  days 
later,  when  it  fell  to  38°.  From  April  1st  to  November  1st  it  was 
rainless  and  absolutely  clear.  During  January  and  February  2  or 
3  inches  of  rain  fell — invariably  during  the  afternoon. 

The  temperature  never  fell  below  the  freezing-point,  but  there 

1  "  This  abused  word  is  pure  Aymara,.  The  j  has  the  sound  of  German  ch;  the  ch  its  invari- 
able Spanish  value,  as  in  church."    Charles  P.  Lummis. 

-  Around  and  About  South  America.    Frank  Vincent. 

3  Fuller  results  of  the  observations  taken  at  the  Observatory  in  Arequipa  will  probably 
appear  later  in  ;the  Annals  of  Harvard  College  Observatory.  See  article  by  A.  Lawrence 
Rotch  in  American  Meteorological  Journal,  October,  1893,  referring  to  the  first  station  on  Char- 
chani.  The  higher  station  on  El  Misti  was  building  about  the  time  of  that  publication  in 
October,  1893. 


SOUTH  AMERICA.  373 

were  occasional  frosts.  Tlie  wind-movement  was  moderate,  the 
greatest  velocity  having  been  17  miles  per  hour  in  December.  The 
air  was  usually  clear  aud  dry,  although  the  lowest  relative  humidity 
mentioned,  35  per  cent.,  would  not  indicate  a  condition  of  dryness 
quite  as  great  at  the  same  temperature  as  that  of  the  Rocky  Moun- 
tain plateau  in  Colorado  or  New  Mexico. 

Jauja  and  Tarma,  situated  in  the  well- sheltered  valley  of  Jauja, 
at  about  10,000  feet  elevation,  are  health-resorts  of  considerable 
repute,  the  former  being  used  by  the  Peruvian  Government  as  a 
sanatorium  for  military  consumptives.  The  mean  annual  tempera- 
ture of  Jauja  is  stated  by  Archibald  Smith  to  be  between  50°  and 
60°  F.,  and  that  of  Huencayo,  which  is  slightly  less  elevated,  as 
between  51°  and  63°. 

Arg-entine  Republic.  Scrivener  recommends  the  mountain-dis- 
tricts of  this  region,  particularly  for  consumptives. 


CHAPTER    XVII. 


EUROPE. 


Europe  is  the  smallest  of  the  great  continental  divisions  of  the 
globe,  and  is  but  a  third  larger  than  the  United  States  exclusive  of 
Alaska.  It  projects  so  far  from  the  vast  body  of  the  Asiatic  conti- 
nent as  to  have  been  termed  the  Western  Peninsula  of  Asia.  From 
its  eastern  frontier  stretches  for  five  thousand  miles  the  land-surface 
of  Asia,  giving  a  continental  character  to  the  climate  of  Eastern 
Europe,  as  shown  in  the  cold  winters  and  hot  summers  of  the  great 
plain  of  Russia,  which  is  too  far  removed  to  receive  more  than  a 
slight  and  intermittent  influence  from  the  Atlantic. 

Western  Europe,  on  the  other  hand,  the  shores  of  which,  with 
their  numerous  promontories  and  off-lying  islands,  project  into  this 
great  ocean,  has  an  equable  climate,  owing  to  the  currents  which 
touch  the  coasts  and  to  the  moist,  warm  winds  which  blow  off  this 
immense  body  of  salt  water.  This  sea-influence  is  increased  by  the 
Mediterranean,  which  washes  the  southern  shores.  The  climate  of 
southern  Europe  is  also  affected  by  its  proximity  to  the  continent 
of  Africa,  and,  as  its  most  southerly  points  lie  within  9°  of  the 
Tropic  of  Cancer,  its  temperature  is  higher  than  that  of  western 
and  middle  Europe.  These  are  chiefly  situated  within  the  cool 
belt,  though  the  northern  limits  are  actually  within  the  frigid 
regions  of  the  Arctic  Circle.  The  bulk  of  the  European  continent, 
therefore,  has  a  cool,  temperate  climate,  its  equability  being  insured 
by  the  modifying  influence  of  the  seas  which  partially  surround  it. 
Owing  to  the  Atlantic  winds  and  to  that  great  branch  of  the  Gulf- 
stream  which  flows  toward  its  shores,  the  climate  of  western  Europe 
is  much  milder  than  that  of  the  Atlantic  and  Arctic  coasts  of  North 
America,  which  lie  at  an  equal  distance  from  the  equator. 

The  moisture  which  is  absorbed  by  the  westerly  winds  as  they 
cross  the  Atlantic  brings  a  heavy  rainfall  to  western  Europe,  the 
precipitation  lessening,  but  still  remaining  high,  until  it  reaches  the 
eastern  plains,  where  it  becomes  very  moderate. 

"Europe,"  writes  Davis,  "may  be  divided  into  three  regions — 


!****<(. 


/     1 


•.'^ 


^  / 


•^n  '. 


K 


X. 


"X 


o 

PC 

W 

I— I 

.-J 


t^ 


^W-^       4. 


t1 


'**4"^, 


From  bdtlek's  geographies,  by  permission  of  e.  h.  butler  &  co.    Copyright,  1888. 


EUROPE.  375 

mountainous  highlands  in  the  southwest,  lower  highlands  in  the 
northwest,  with  lowlands  between  the  highland  regions,  and  also 
spreading  far  to  the  northeast.  Many  peninsulas  and  seas  make 
the  coast  of  Europe  more  irregular  than  that  of  any  other  continent."^ 

With  respeet  to  its  rainfall,  the  greater  part  of  Europe  belongs  to 
the  zone  of  irregular  seasonal  distribution.  While  the  southern 
portion,  with  its  dry  summers,  l»eloDgs  to  the  subtropical  zone, 
''the  line  of  demarcation  runs  at  a  little  distance  to  the  north  of 
the  Spanish  coast  of  the  Bay  of  Biscay,  continues  along  the  northern 
slope  of  the  Pyrenees,  turns  northeastward  to  the  neighborhood  of 
Valence  on  the  Rhone,  curves  southward  to  Genoa,  follows  the  line 
of  the  northern  Apennines,  strikes  across  the  Adriatic  from  Rimini 
to  the  neighborhood  of  Zara,  and  proceeds  by  way  of  Seraievo,  Novi- 
Bazar,  and  Sofia  to  the  coast  of  the  Black  Sea,  south  of  Zozopoli. 
Within  the  subtropical  zone  the  maximum  rainfall  occurs  during 
winter  in  the  south  of  Spain  and  Italy  ;  during  autumn  and  winter 
in  central  and  northern  Spain,  the  south  of  France,  and  northern 
and  central  Italy.  In  the  zone  of  irregular  distribution  Scotland, 
Ireland,  and  western  England  have  their  maximum  in  winter ; 
western  France,  eastern  England,  the  coast  regions  of  the  Low 
Countries  and  Denmark,  and  the  greater  proportion  of  Norway 
have  theirs  in  the  autumn  ;  while  in  eastern  France,  the  German 
Empire,  Austria,  Hungary,  Russia,  and  Sweden  it  falls  in  sum- 
mer.   " 

In  northwestern  England,  at  Stye  Head  Pass,  the  greatest  pre- 
cipitation is  recorded  (189.49  inches),  while  the  least  occurs  in  the 
almost  rainless  region  around  the  Caspian  Sea.'^ 

The  prevalent  winds  of  western  Europe  are  southwest  and  west 
southwest ;  in  southeastern  Europe  winds  most  frequently  blow 
from  the  north  and  east,  the  latter  being  more  prevalent  in  the 
winter  and  autumn.^  Hurricanes  are  rare,  but  westerly  storms 
cross  the  continent  six  or  seven  times  during  the  winter.  The  chief 
local  winds  are  the  dry,  warm  F5hn  of  the  Alps,  which  resembles 
the  '' Chinook"  of  the  Rocky  Mountain  region  of  North  America, 
the  violent  Boro  wind  of  the  upper  Adriatic  region,  the  Etesian 
winds  of  the  Mediterranean,  the  mistral  of  southern  France,  and 
the  hot,  desiccating  sirocco  from  the  African  deserts. 

1  Frye's  Geography,  p.  75.  -  The  Encyclopsedia  Britannica. 

3  Dr.  otto  Krumel :  Ztsohr.  fUr  Erdkunde  zu  Berlin,  1878. 
*  Wesselovski :  Encyclopsedia  Britannica. 


376  MEDICAL  CLIMATOLOGY. 

The  snow-line  varies  greatly  in  different  localities,  ranging  from 
8860  feet  in  the  western  and  central  Alps  to  1400  feet  on  the  eastern 
slopes  of  the  Caucasus  Mountains.  The  average  height  is  lower  in 
the  Alps  than  in  the  Rockies. 

The  British  Isles. 

This  dominion  consists  of  two  large  islands  and  many  small  ones. 
Great  Britain,  the  largest  of  these,  although  it  is  the  most  important 
island,  in  the  world,  is  only  one-fortieth  the  size  of  the  United  States 
of  America. 

While  they  lie  in  the  same  latitude  as  Labrador,  which  has  a  cold 
and  severe  climate,  that  of  these  islands  is  mild,  with  even  seasons, 
owing  to  the  ameliorating  influence  upon  the  west  winds  of  that 
great  branch  of  the  North  Atlantic  eddy  which  flows  along  the 
British  coast. 

The  rainfall  is,  generally  speaking,  heavy,  especially  on  the  west- 
ern shores,  and  the  air  is  humid.  To  these  prevailing  conditions 
there  are,  however,  many  remarkable  local  exceptions. 

The  laud  in  the  northern  and  western  parts  of  Great  Britain  is 
moderately  high,  and  in  northern  Scotland  it  is  very  rugged.  In 
these  regions  the  rocky  shores  are  much  indented  by  lochs  and  bays 
which  are  studded  with  small  islands.  The  southern  and  eastern 
portions  are  chiefly  lowlands,  and  the  shores  are  of  sand  or  clay. 

Ireland,  lying  furthest  to  the  west  and  being  first  exposed  to  the 
western  gales,  receives  more  rain,  and  the  climate  is,  for  the  same 
reason,  damper.  The  surface  of  Ireland  is  chiefly  low  and  flat,  and 
there  are  large  areas  of  bog.  Near  the  coast,  however,  there  are 
some  moderate  elevations. 

Ireland. 

The  coasts  of  Ireland  and  Scotland  are  dotted  with  beautiful  re- 
sorts, many  of  which  afford  good  sea-bathing.  The  climate  of  Ire- 
land is  unsuited  to  the  needs  of  most  health-seekers,  especially  con- 
sumptives ;  the  death-rate  from  consumption  is  extremely  high, 
being  14.9  per  cent,  of  all  deaths,  which  is  higher  than  the  percent- 
age for  any  other  part  of  the  British  Isles.  But  the  coasts  afford 
some  pleasant  summer-resorts,  and  the  sedative  character  of  the  air 
renders  them  advantageous  to  certain  classes  of  invalids.  On  the 
Atlantic  coast  the  resorts,  while  affording  good  bathing  and  possess- 
ing a  healthy  and  bracing  climate,  are,  of  course,  more  windy  and 


EUROPE.  377 

more  subject  to  fogs  and  mists.  Among  them  may  be  mentioned 
Bandarem,  on  Donegal  Bay;  Kilkee,  in  County  Clare;  and  Kil- 
rush,  at  the  mouth  of  the  river  Shannon. 

Gleng-arrifif,  near  Bantry  Bay,  has,  like  Queenstown,  a  southern 
aspect,  and  is  much  sheltered  from  cold  winds.  Its  situation  is 
beautiful  and  interesting,  and  the  climate  lacks  severity  and  is 
equable. 

Queenstown,  situated  in  the  Cove  of  Cork,  is  built  in  terraces 
on  a  hillside,  which  protects  it  to  the  north,  but  leaves  an  open 
aspect  to  the  south.  It  has  a  mild  climate,  not  subject  to  sudden 
changes  of  temperature.  The  mean  annual  temperature  is  51.9°  F. ; 
the  mean  temperature  for  spring  is  50.17°,  and  for  winter  44.2°; 
and  the  annual  rainfall  is  34  inches. 

Among  popular  summer-resorts  with  good  bathing  may  be  men- 
tioned Bray,  Dun  drum,  Kingstown,  on  the  eastern  coast;  Howth, 
on  Dublin  Bay;  Rosstrevor,  New  Castle,  Holywood,  and  Dona- 
g-hadee.  The  climate  for  all  these  places  may  be  characterized  as 
mild  and  damp. 

Portrush  and  Port  Stewart,  lyiug  on  the  north  coast,  have  a 
climate  more  tonic  in  its  effects  than  the  resorts  just  mentioned,  and 
Portrush  especially  is  quite  popular. 

County  Clare  has  also  sulphur  and  iron  springs,  located  at  the 
town  of  Lisdunvarna,  and  their  local  fame  is  considerable. 

Scotland. 

Scotland  is;  on  the  whole,  a  harsher  but  more  invigorating  climate 
than  Ireland,  and  the  consumptive  death-rate  is  not  so  high,  being 
13.8  per  cent,  of  all  deaths. 

The  west  coast  is  very  beautiful  and  attractive,  and  its  summer 
climate  is  mild  but  very  humid;  the  number  of  rainy  days  is  great 
and  fogs  are  frequent.  The  east  coast  is  drier  and  brighter,  but  not 
so  equable. 

The  air  of  the  moorlands  of  the  interior  is  keen  and  bracing,  but 
except  for  a  few  weeks  in  the  early  summer  rains  and  mists  are 
common.  For  invalids  who  are  strong  enough  to  exercise,  espe- 
cially if  they  are  able  to  take  advantage  of  the  opportunities  for 
sport,  and  to  endure  the  humidity,  the  moorlands  often  prove  a  good 
tonic  during  the  summer  and  early  autumn. 

Durinw  the  same  season  the  climate  of  some  of  the  islands  off  the 


378  MEDICAL  CLIMATOLOGY. 

coast  is  very  pleasant  because  of  its  mildness  and  equability,  and 
the  primitiveuess  of  the  surroundings  often  affords  a  healthy  change 
for  the  invalid  accustomed  to  luxury. 

Scotland  has  many  resorts  which  would  deserve  a  longer  notice 
could  more  definite  statistical  information  in  regard  to  them  be 
obtained.      We  may,  however,  mention  the  following  : 

Oban  is  prettily  situated  on  the  shores  of  a  bay  in  Argyleshire, 
and  has  about  2000  inhabitants.  The  scenery  has  been  highly 
praised,  and  the  writings  of  Mr.  William  Black  have  made  the  place 
widely  known.  The  neighborhood  is  interesting  and  beautiful.  It 
is  coniins;  more  and  more  into  favor  as  a  summer  health-resort. 

Helensburgh,  which  is  not  far  from  Dumbarton,  is  situated  on 
the  river  Clyde.  Like  many  of  the  Scotch  summer-resorts,  its 
climate  possesses  both  mildness  and  equability,  and  it  is  recommended 
for  throat  and  bronchial  affections. 

Rothesay,  on  the  west  coast  and  to  westward  of  the  Firth  of 
Clyde,  is  used  both  in  winter  and  in  summer.  Situated  amidst 
beautiful  scenery  and  affording  good  bathing,  it  has  in  its  climate 
an  additional  advantage,  the  temperature  being  characterized  by 
both  mildness  and  equability.  It  is  seldom  that  the  heat  in  sum- 
mer is  greater  than  70°  F.,  and  the  thermometer  rarely  falls  below 
freezing-point. 

Ardrossan,  on  the  coast  of  Ayrshire,  affords  good  sea-bathing. 
The  summer  climate  is  mild,  damp,  and  equable. 

North  Ber-wick,  situated  about  twenty  miles  from  Edinburgh, 
possesses  a  good  beach  and  large  golf-links.     Its  climate  is  bracing. 

St.  Andrews  is  located  on  the  coast  of  Fifeshire.  The  climate 
is  healthy,  but  the  place  is  much  exposed  to  the  northeast  winds 
which  prevail  during  the  spring  season.  Here  are  the  oldest  and 
most  celebrated  golf-links  in  the  world,  and  the  town  and  its  situa- 
tion are  interesting  and  delightful. 

Stonehaven,  a  few  miles  south  of  Aberdeen,  is  charmingly  situated 
and  affords  good  bathing.    The  atmosphere  is  tonic  and  invigorating. 

Strathpeffer,  situated  in  a  valley  near  Dingwall,  in  the  northern 
part  of  Rossshire,  has  strong  sulphur  springs,  a  bathing  and  drink- 
ing establishment,  and  a  fine  hotel.  The  climate  is  fairly  good,  but 
the  advent  of  a  rainy  season  may  render  the  place  undesirable. 

Nairn,  on  the  bank  of  the  river  N^airn,  is  about  eighteen  miles  to 
the  northeast  of  Inverness.  It  is  a  much-patronized  resort,  has  a 
good  beach,  and  is  easy  of  access.      It  has  been  recommended  as  a 


EUROPE.  379 

winter-resort,  but  detailed  information  as  to  its  merits  is  not  forth- 
coming. 

At  Crieff,  a  finely  situated  resort  in  Perthshire,  is  a  well-arranged 
hydropathic  establishment.      The  climate  is  bracing. 

At  the  Bridge  of  Allan,  a  beautiful  spot  near  Stirling,  is  a  salt 
spring.    The  situation  of  the  place  is  protected  and  the  climate  mild. 

Moffatt,  in  Dumfriesshire,  lying  at  an  elevation  of  400  feet  above 
the  sea-level,  has  a  cold  sulphur  spring,  the  waters  of  which  con- 
tain sulphuretted  hydrogen,  sulphate  of  sodium,  and  common  salt. 
The  climate  is  healthy.  There  is  a  very  well  and  favorably  known 
hydropathic  establishment  at  MofPatt. 

England. 

Different  parts  of  England  show  considerable  variation  in  their 
climates.  Speaking  broadly  it  may  be  said,  however,  that  it  is 
not  so  mild  and  damp  as  Ireland,  nor  so  bracing  and  harsh  as  Scot- 
land. The  death-rate  from  consumption  is  lower  than  in  either, 
being  12.3  per  cent,  of  all  deaths. 

The  resorts  on  the  west  coast  of  England  are  both  warmer  and 
moister  than  those  on  the  east  coast,  for  they  border  upon  a  warmer 
sea,  and  warmer,  damper  winds  prevail.  In  winter  the  difference 
in  temperature  is  from  3°  to  6°  in  favor  of  the  west  coast,  but  this 
is  lessened  upon  the  approach  of  spring,  and,  in  summer,  warm 
winds  blowing  off  the  continent  may  cause  a  positive  reversal  of 
the  conditions  mentioned  above.  Resorts  on  the  east  coast,  being 
cooler  and  drier,  are  consequently  more  bracing. 

The  County  of  Cornwall,  a  promontory  which  constitutes  the 
southwest  corner  of  England  and  terminates  in  Laud's  End,  has  a 
climate  differing  from  the  rest  of  the  island  and  resembling  that  of 
the  Riviera  in  winter.  It  is  5°  cooler,  the  relative  humidity  being 
about  10  per  cent,  higher.  The  rainfall  and  the  number  of  rainy 
days  are  decidedly  greater.  The  temperature-range  is,  however, 
much  less,  and  the  climate  is  milder  and  more  equable,  but  less 
stimulating;  while  fairly  sunny,  it  is  not  so  bright  as  that  of  the 
Mediterranean  shores.  Here  will  be  found  flowering  in  winter 
many  exotic  and  subtropical  plants  ;  the  early  flowers  and  vege- 
tables of  the  Scilly  Isles  are  especially  celebrated,  and  the  climate 
of  these  attractive  islands  has  been  recommended  for  invalids. 

This  promontory  is  eighty  miles  in  length,  or  thereabout,  and  forty 


380  MEDICAL  CLIMATOLOGY. 

at  its  base,  narrowing  down  to  an  average  breadth  of  twenty  miles. 
On  its  southern  shore  is  the  English  Channel  and  on  its  northern  the 
Atlantic  Ocean.  Being  about  one  hundred  miles  from  the  coast  of 
France,  it  is  so  situated  that  it  enjoys  the  advantages  of  an  island 
climate,  which  gives  to  it  its  equability,  while  the  influence  of  the 
Gulf-stream  increases  its  temperature  above  that  normal  to  its  lati- 
tude and  adds  to  its  humidity.  The  land  rises  from  the  shore  to  a 
height  of  600  feet,  this  being  the  average  height  of  the  range  of  hills 
which  runs  through  the  length  of  Cornwall.  This  range  gives 
shelter  to  its  shores,  and  especially  to  the  southern  coast,  which  is 
thus  protected  from  Atlantic  gales.  Throughout  this  district,  there- 
fore, but  particularly  on  the  southeast  coast,  is  found  a  climate  well 
adapted  for  English  invalids  who  seek  an  easy  and  pleasant  escape 
from  the  fickle  chilliness  of  their  homes  in  other  parts  of  the  island.^ 

Only  some  of  the  most  frequented  and  characteristic  of  the 
numerous  English  resorts  can  be  described. 

Dr.  Weber,  in  comparing  the  resorts  of  England  with  those  of  the 
European  continent,  writes  as  follows  : 

''On  the  whole,  we  might  say  of  Euglish  resorts  that  the  climate 
is  healthy  and  invigorating,  though  not  agreeable,  and  that  to  a  cer- 
tain extent  it  requires  powers  of  resistance. 

"The  climatic  characteristics  of  English  seaside-places  may  thus 
be  summarized  :  greater  warmth  than  is  due  to  latitude  ;  equability 
of  temperature  as  regards  different  seasons  and  times  of  day  ;  a  com- 
paratively high  amount  of  humidity  ;  a  dull  atmosphere,  with  little 
sunshine;  and  very  favorable  hygienic  and  dietetic  conditions." 

Coast  Resoets. 

Dr.  Braun  says:  '"England  is  remarkably  well  prov^ided  with 
seaside-places,  with  excellent  air  and  good  opportunity  for  sea- 
bathing." 

Llandudno,  a  pleasant  but  somewhat  rainy  resort  in  Wales,  also 
comes  under  the  head  of  equable  and  moist  climates,  and  is  some- 
times used  in  the  winter  season.  The  mean  winter  temperature  is 
43.7°  F.     The  mean  humidity  is  about  the  same  as  that  of  Hastings. 

Tenby,  lying  on  the  south  coast  of  Wales,  has  a  moderately  dry, 
mild  marine  climate.  It  is  nine  hours'  journey  by  fast  train  from 
London.      It  stands  upon  a  rocky  peninsula  which  attains  an  eleva- 

1  Sir  Joseph  Fayrer  writes  from  personal  experience  very  enthusiastically  of  this  district  in 
an  article  upon  Falmouth,  in  the  Journal  of  the  British  Medical  Association  of  August  29, 
1896,  from  which  much  of  this  information  is  taken. 


EUROPE.  381 

tion  of  100  feet  above  sea-level.  There  are  admirable  sanitary 
arrangements,  the  water-supply  is  good,  and  the  houses  are,  for  the 
most  part,  well  built  and  substantial.  There  is  a  magnificent  beach 
which  affords  good  bathing-facilities,  and  there  are  all  the  diversions 
usually  to  be  found  at  seaside-resorts.  During  the  year  1882  the 
lowest  temperature  was  reached  on  December  10th,  when  the  ther- 
mometer stood  at  32°  F.,  and  the  highest  on  August  9th,  when  it 
registered  90°. 

Ilfracombe,  on  the  shore  of  the  Bristol  Channel,  is  finely  situated 
on  a  beautiful  rocky  coast,  has  a  bracing  climate,  somewhat  like  that 
of  Brighton,  and  is  very  pleasant  for  summer  residence.  The  arrange- 
ments for  taking  sea-baths  are  unusually  good,  and  they  include  a 
swimming-bath  of  considerable  size,  which  is  filled  by  every  incom- 
ing tide.  There  is  not  so  much  rain  as  at  Torquay.  Many  enjoyable 
trips  may  be  taken  from  Ilfracombe  through  a  picturesque  country. 

Falmouth,  which  lies  on  the  southern  coast  of  Cornwall,  is  an 
example  of  the  climate  of  the  southwestern  part  of  England.  It  is 
situated  on  the  shores  of  a  fine  harbor,  and  as  the  ground  rises  from 
the  shore  the  town  is  built  in  terraces  upon  a  hillside.  The  coast 
consists  of  strips  of  beach  alternating  with  stretches  of  high  cliff, 
from  which  the  views  are  very  fine.  Owing  to  the  mildness  and 
dampness  of  the  climate  the  vegetation  is  luxuriant  and  beautiful, 
and  the  neighborhood  has  many  charming  country-seats.  The 
accommodations  at  Falmouth  are  very  fair,  but  far  less  has  been 
done  to  attract  visitors  than  at  other  seaside-resorts  possessing  such 
natural  advantages.  Although  the  amount  of  rainfall  is  large,  the 
storms  are  rarely  of  long  continuance,  and  the  soil,  being  gravelly, 
is  porous  and  dries  quickly.  Annexed  is  a  table  taken  from  Sir 
Joseph  Fayrer's  article,  already  referred  to,  which  shows  the  tem- 
perature of  Falmouth  as  compared  with  that  of  some  islands  and  of 
several  towns  belonging  to  the  Riviera  and  to  the  Pyreuean  regions: 

November.  December.  January.       February.  March. 

Falmouth,     47.8°  44.3°  44.1°  45.1°  44.7° 

Penzance,     47.26  45.17  45.21  45.20  45.32 

Scilly,  49.8  46.7  46.8  46.9  46.4 

Cannes,         52.6  46.3  48.0  48.8  57.0 

Montpellier,  50.7  45.7  42.1  44.8  48.9 

Mentone,       54.0  49.1  48.7  49.1  52.8 

Nice,  53.8  48.5  47.1  46.2  51.8 

Pan,  47.0  42.8  41.2  43.6  48.8 

Madeira,        64.96  62.58  61.89  62.7  64.0 


382  MEDICAL  CLIMATOLOGY. 

Torquay,  beautifully  situated  on  the  north  shore  of  Tor  Bay,  has 
a  particularly  well-sheltered  location  and  a  warm,  moist,  very  relax- 
ing climate.  The  annual  rainfall  is  over  39  inches,  distributed 
through  200  rainy  days.  The  town  is  well  regulated  ;  there  are  an 
adequate  supply  of  pure  water  and  a  good  sewerage  system.  There 
are  ample  and  excellent  accommodations.  It  is  warmer  and  more 
relaxing  than  Bournemouth. 

Bournemouth.  Tliis  health-resort  has  a  sheltered  situation  on 
sand-hills  wooded  with  pine.  The  bay  lies  open  to  the  southwest, 
but  is  protected  on  the  northwest,  north,  and  northeast.  It  has  a 
moist,  equable  temperature,  drier  than  Torquay.  In  January  the 
average  of  the  minima  is  35°  F,  while  in  Julv  the  average  of  the 
maxima  is  71°.  By  seasons  the  mean  temperature  is  :  for  winter, 
42°;  spring,  49°;  summer,  60°;  autumn,  52°.  The  yearly  rainfall 
is  about  30  inches,  with  from  120  to  160  rainy  days.  The  relative 
humidity  is  from  75  to  86  per  cent. — usually  in  the  vicinity  of 
80  per  cent.  It  is  a  very  much-used  resort  in  winter  for  chest- 
cases.     There  are  first-class  hotels  and  lodgings. 

Ventnor  is  charmingly  placed  on  the  south  coast  of  the  Isle  of 
Wight,  the  town  being  built  in  terraces  on  the  side  of  the  Under- 
cliff.  It  is  used  both  in  winter  and  summer  as  a  health-resort.  The 
situation  is  sheltered  and  the  climate  mild  and  free  from  sudden 
changes  of  temperature.  There  is  a  j^atioual  Hospital  for  Con- 
sumptives at  Ventnor,  the  arrangement  of  which  is  exceptionally 
good. 

Brighton  is  on  the  south  coast  of  England,  and  within  an  hour's 
journey  by  rail  from  London.  The  season  is  during  the  winter. 
There  are  good  hotels  and  all  the  attractions  of  a  city  by  the  sea. 
It  is  regarded  as  having  a  climate  generally  warm  but  stimulating, 
and  there  are  much  more  sunlio-ht  and  less  fog  than  in  London. 
The  air  on  the  chalk-downs  behind  the  town  is  considered  very 
fine.  The  mean  temperature  for  January  is  39°  F.;  for  April,  49°; 
for  July,  62°;  for  October,  52°;  for  the  year,  50°.  The  soil  is  dry 
and  the  air  less  moist  than  at  Bournemouth.  The  annual  rainfall 
is  26|  inches.     It  is  somewhat  windy. 

Eastbourne,  situated  between  St.  Leonards  and  Brighton,  on  the 
coast  of  Sussex,  is  a  well-laid  out  town,  extending  some  three-quar- 
ters of  a  mile  back  from  the  seashore.  Thus,  patients  who  come 
here  may  be  directly  under  the  influence  of  the  sea-air  or  they  may 
enjoy  the  more  bracing  atmosphere  of  the  extensive  downs  which  lie 


EUROPE.  383 

inlaod.  The  water-supply  is  good  and  the  sanitary  arrangements 
are  excellent.  There  are  many  amusements  for  the  visitor  at  East- 
bourne— riding,  driving,  swimming,  and  varieties  of  sea-baths,  lawn- 
tennis,  etc.,  and  other  pleasant  diversions  are  to  be  found  in  the 
agreeable  Devonshire  Gardens.  There  is  a  magnificent  view  over 
the  ocean  from  the  fine  promontory  known  as  Beachy  Head.  The 
promenades  are  furnished  with  seats  and  sheltered  lounges,  and  are 
lit  by  electricity.  Eastbourne  is  a  somewhat  more  fashionable 
resort  than  those  previously  mentioned,  and  has  a  larger  permanent 
population. 

St.  Leonards,  also  known  as  a  winter-resort,  may,  in  all  its  main 
characteristics,  be  classed  with  Hastings,  to  which  it  is  joined.  St. 
Leonards  is  more  open  and  rather  more  bracing  than  Hastings,  and 
is  a  very  attractive  place,  with  handsome  hotels  and  residences. 

Hasting-s,  situated  about  thirty  miles  from  Folkestone,  looks 
toward  the  south,  and  is  sheltered  by  high  cliffs  from  winds  blow- 
ing from  the  north  and  northeast.  It  is  known  chiefly  as  a  winter- 
resort.  The  autumn  here  is  pleasant,  but  the  spring  is  cold  and  windy. 
The  soil  is  sandy  and  porous,  and  the  water-supply  and  the  drain- 
age-system are  good.  Fogs  are  rare,  and  the  temperature,  both  for 
winter  and  summer,  is  very  even.  There  is  a  pier  at  Hastings,  and 
a  pavilion  in  which  daily  concerts  are  given,  and  the  neighborhood 
abounds  in  points  of  interest,  affording  an  object  for  excursions. 

Folkestone,  built  upon  a  cliff  of  green  sand,  fifty  feet  above  sea- 
level,  which  gives  it  a  pleasant  elevation  and  openness,  is  a  very 
popular  health-resort.  There  is  an  ample  supply  of  pure  water, 
and  the  town  has  a  good  drainage-system.  The  rainfall  for  the 
year  is  said  to  be  about  25  inches.  The  air  is  stimulating.  The 
roads  are  good,  there  are  plenty  of  attractive  walks  and  drives,  and 
the  resort  is  an  eminently  cheerful  place. 

Dover,  situated  on  the  south  coast,  has,  during  most  of  the  year, 
a  climate  dry,  tonic,  and  invigorating ;  but  the  locality  is  subject  to 
the  disadvantages  of  great  cold  in  January,  high  winds  in  March, 
and  extreme  heat  in  July.  It  is,  to  some  extent,  protected  from 
winds  blowing  from  the  north,  northeast,  and  northwest  by  the 
chalk-hills  which  lie  at  the  rear  of  the  town.  The  subsoil  is  chalk, 
but  most  of  the  houses  are  built  upon  the  beach,  where  the  surface- 
soil  is,  of  course,  porous  and  drains  quickly.  The  water-supply, 
derived  from  wells  sunk  in  the  chalk  to  a  depth  of  226  feet,  is  pure 
and  plentiful,  and  the  sanitary  arrangements  in  general  are  good. 


384  MEDICAL  CLIMATOLOGY. 

Ramsgate  is  reached  over  the  Chatham  and  Dover  Railroad  in 
two  hours,  or  by  steamer  from  London  Bridge  in  six  hours,  and, 
during  the  season,  small  steamers  also  run  between  this  point  and 
Sandwich,  Dover,  and  Deal.  The  climate  is  warmer  than  that  of 
Margate,  because  the  situation  is  more  sheltered  from  the  sweep  of 
the  northerly  and  northeasterly  winds.  Ramsgate  has  a  fine  bath- 
ing-beach, and  there  are  attractive  drives  through  the  neighborhood 
to  Canterbury  and  Folkestone,  but  it  is  not  so  lively  a  place  as 
Margate.  The  town  itself  lies  between  two  cliffs,  the  east  and  the 
west,  where  most  of  the  visitors  congregate.  The  Eastcliff  Hotel, 
with  its  abundant  and  complete  facilities  for  all  sorts  of  sea-baths, 
deserves  especial  mention. 

Broadstairs,  lying  between  Margate  and  Ramsgate,  is  a  much 
quieter,  less  pretentious  resort  than  either  of  them.  It  has  a  good 
beach,  which  affords  safe  bathing,  but  the  laud  in  the  immediate 
neighborhood  rises  to  a  height  of  from  120  feet  to  150  feet  above 
sea-level.  Like  Margate,  Broadstairs  stands  upon  ground  having  a 
chalky  subsoil.  The  water-supply  is  pure  and  abundant,  and  sani- 
tary regulations  are  strictly  enforced. 

Margate,  reached  in  two  hours  from  London  by  rail  and  in  five 
hours  by  river  steamer,  is  one  of  the  most  popular  of  English  re- 
sorts. The  subsoil  of  this  locality  is  chalky,  so  that  after  a  rain 
the  ground  dries  quickly.  Although  it  is  subject  to  high  winds, 
Margate  has  a  bracing  and  comparatively  dry  climate,  and  the 
extensive  beach  affords  good  bathing,  particularly  for  those  who 
do  not  care  to  try  deep  water.  The  place  is  considered  especially 
good  for  scrofulous  troubles,  and  is  the  seat  of  the  Royal  National 
Hospital  for  Scrofula.  While  situated  near  Ramsgate  on  the  east 
coast,  Margate,  from  the  peculiarity  of  its  location  on  the  peninsular 
jut  of  land  just  below  the  Thames's  mouth,  has  a  northerly  or 
northeasterly  exposure,  and  in  the  spring,  when  northeasterly  winds 
prevail,  it  is,  in  consequence,  one  of  the  few  resorts  in  this  vicinity 
which  have  a  sea-breeze.  There  are  good  accommodations  to  be 
had,  both  as  regards  hotels  and  lodging-houses.  The  Clifton  ville 
Hotel  is  situated  on  the  higher  ground  known  as  the  Cliff,  but  the 
less  expensive  hotels  and  boarding-houses  are  on  lower  ground  close 
to  the  harbor  and  pier.  During  the  summer  Margate  is  a  very 
popular  point  for  cheap  excursions. 

Felixstowe  is  situated  on  the  Suffolk  coast,  near  Ipswich,  and 
has  a  southerly  outlook.      The  air  is  bracing  and  comparatively 


EUROPE.  385 

dry,  and  the  weather  is  fairly  good  up  to  the  latter  part  of  Febru- 
ary. The  water  is  pure  and  contains  a  little  iron.  There  is  a  first- 
class  hotel,  "■  The  Bath",  and  every  facility  for  good  and  safe  bath- 
ing.    There  are  also  very  well-known  golf-links  here. 

Bridlington  and  Filey  are  two  pleasant  seaside-places  a  little  to 
the  south  of  Scarborough. 

Scarboroug-h,  in  Yorkshire,  five  and  one-half  hours  by  rail  from 
London,  is  a  favorite  seashore-resort.  It  is  reached  over  the  Great 
Northern  Railroad.  It  has  an  elevation  of  100  feet  above  the  sea, 
being  built  upon  precipitous  cliffs.  Castle  Hill,  to  the  northeast  of 
the  town,  and  Oliver's  Mountain,  more  to  the  south,  reach  a  height 
of  285  feet  and  500  feet,  respectively.  Besides  its  healthful  situa- 
tion and  its  tonic  climate,  Scarborough  has  claims  to  favorable  con- 
sideration as  a  health-resort  in  that  it  is  a  well-regulated  town,  but 
its  many  diversions  and  gaieties  render  it  more  particularly  agreeable 
to  those  who  are  dissatisfied  with  the  quiet,  monotonous  life  which 
is,  nevertheless,  most  suitable  for  a  large  class  of  invalids.  The 
mean  annual  temperature  is  46.7°  F.,  and  the  annual  and  daily 
range  is  small,  Scarborough  possesses  a  fine  beach,  and  at  the  Spa 
are  chalybeate  and  saline  springs. 

"Whitby,  a  town  whose  chief  industries  are  fishing  and  shipbuild- 
ing, is  also  well  known  as  a  summer-resort  of  no  mean  attractions. 
It  lies  on  the  coast  of  Yorkshire.  There  is  a  good  water-supply 
and  adequate  and  complete  sanitary  arrangements.  Boating,  bath- 
ing, and  fishing  are  among  the  amusements,  and  there  is  a  building 
for  concerts,  balls,  etc.,  and  a  good  public  library.  There  are  two 
excellent  hotels,  the  ''Royal"  and  the  "Crown,"  and  many  good 
lodging-houses. 

Inland  Resorts. 

Ilkley,  in  Yorkshire,  not  far  distant  from  Matlock,  is  a  health- 
resort  possessing  a  fine  air  and  a  bracing  climate.  Here  are  located 
establishments  for  the  purpose  of  enabling  patients  to  undergo 
hydropathic  treatment. 

Buxton  has  an  elevation  of  1000  feet  above  the  ocean,  and  the 
air  is  pure  and  stimulating,  but  the  rainfall  is  great.  It  is  more 
shut  in  than  Ilkley.  Buxton  has  simple  thermal  springs  which 
Yeo  speaks  of  as  resembling  Ragatz  and  Plombieres.  The  waters, 
used  chiefly  for  bathing,  are,  he  says,  efficacious  in  gout,  rheuma- 
tism, joint-afFections,  etc. 

25 


386  MEDICAL  CLIMATOLOGY. 

Matlock,  in  Derbyshire,  situated  amidst  beautiful  scenery,  pos- 
sesses a  fine,  bracing  climate  and  several  springs,  of  wiiich  carbonate 
of  lime  is  the  chief  solid  element.  Here  is  located  a  well-known 
establishment  for  the  hydropathic  treatment  of  such  disorders  as 
dyspepsia,  chronic  rheumatism,  and  glandular  affections. 

"Woodhall  Spa,  in  Lincolnshire,  some  eighteen  miles  from  the 
coast,  is  situated  in  a  district  which  is  said  to  have  the  smallest 
rainfall  of  any  in  England,  very  little  over  20  inches.  The  subsoil 
is  dry  sand,  and  the  climate  is  invigorating.  The  "  bromo-iodine 
spring"  at  Woodhall  contains,  as  stated  by  Dr.  Frankland,  4.396 
grains  of  bromine,  0.616  grain  of  iodine,  and  a  little  arsenic  to  a 
gallon  of  water.  There  are  good  accommodations  to  be  found  in 
comfortable  boarding-houses  or  at  the  excellent  Victoria  Hotel. 

Droitwich,  situated  in  Worcestershire,  three  and  one-half  hours' 
journey  by  rail  from  Loudon,  has  strong  salt  springs.  There  is  a 
large  swimming-bath,  the  water  of  which  has  a  temperature  of  80° 
F.,  and  the  water,  used  in  this  way,  is  said  to  be  beneficial  in  certain 
forms  of  gout,  rheumatism,  etc.  There  is  an  excellent  hostelry,  the 
Royal  Brine  Baths  Hotel,  and  boarding  may  also  be  procured  in  the 
town. 

Malvern,  also  in  Worcestershire,  lies  on  the  eastern  slope  of  hills, 
which  render  its  situation  very  sheltered.  The  climate  is  both  bracing 
and  equable,  the  water-supply  is  pure,  and  the  accommodations  are 
good.  Dr.  Charteris  says  of  this  resort  :  '^  I  do  not  know  of  any 
health-resort,  at  home  or  abroad,  more  effective  than  Malvern  for 
restoring  to  its  original  vigor  the  unstrung  nervous  system  or  for 
bringing  back  the  appetite,  jaded  by  late  hours  or  the  luxuries  of 
town-life."     The  hotels  are  excellent  and  the  views  fine. 

Bath,  once  so  popular  a  resort  and  bidding  fair  to  rise  again  into 
notice,  has  indifferent,  earthy,  thermal  springs.  The  chief  solid 
ingredient  of  these  waters  is  sulphate  of  lime.  There  are  four  hot 
springs,  the  temperature  of  which  ranges  from  104°  to  120°  F.,  and 
the  bathing-facilities  are  good.  The  situation  of  the  town  is  some- 
what sheltered  from  the  north  and  east  winds,  and  the  winter-tem- 
perature is  said  to  be  from  3°  to  5°  warmer  than  that  of  London. 
The  climate  is  mild,  moist,  and  sedative.  Bath  is  a  handsome  city, 
with  excellent  hotels  and  lodgings. 

Harrogate  possesses  a  number  of  sulphur  springs,  containing 
sodium  sulphide,  free  sulphuretted  hydrogen,  and  different  amounts 


EUROPE.  387 

of  comraou  salt.  There  are  also  chalybeate  springs  of  varying 
strength.  Tliey  are  used  much  as  are  the  waters  at  Horaburg  and 
Kissingeu,  and  it  is  claimed  that  they  are  useful  in  cases  of  dyspep- 
sia, constipation,  congestion  of  the  liver,  and  in  some  forms  of  skin 
disease.  Harrogate  has  an  elevation  of  430  feet,  and  the  air  is 
pure  and  bracing,  but  the  place  is  rather  windy. 

Norway  and  Sweden 

possess  very  pleasant  summer  climates  with  beautiful  scenery.  A 
trip  around  their  coasts  in  one  of  the  well-fitted,  comfortable  tourist- 
steamers  sailing  from  England  during  the  summer  months  affords 
the  advantages  of  an  agreeable  and  short  sea-trip  for  convalescents, 
for  jaded  citizens,  or  for  the  martyrs  to  hay-fever.  Journeys  through 
the  interior  are  easily  made,  and  to  the  fisherman  Norway  is  espe- 
cially attractive. 

The  North  Sea. 

On  the  coasts  of  the  North  Sea  are  many  more  or  less  well-known 
resorts  which  have  a  bracing,  tonic  atmosphere,  and  there  are  also 
some  islands,  lying  near  the  mainland,  which  are  somewhat  used  as 
summer  health-resorts. 

Heligoland,  owned  by  England,  is  the  best  known  of  these 
island- resorts.  It  lies  six  miles  from  the  mouths  of  the  rivers  Weser 
and  Elbe,  and  steamers  run  between  it  and  Hamburg  and  Bremen. 
The  island  is  formed  of  sandstone  rock,  one  portion  being  consider- 
ably elevated  over  the  other.  Owing  to  its  situation  and  to  its  small 
extent,  Heligoland  has  as  pure  a  sea-climate  as  if,  to  quote  Dr.  Yeo, 
it  were  a  "  ship  anchored  out  at  sea." 

Norderney,  an  island  lying  to  the  southeast  of  Heligoland  and 
much  nearer  the  mainland,  has  the  same  climatic  characteristics. 

Holland. 

In  the  summertime,  for  those  who  need  a  mild,  sedative  climate 
and  do  not  fear  the  dampness,  Holland  is  an  attractive  country 
where  sight-seeing  is  interesting  if  fatiguing.  There  are  several 
pleasant  seaside-places,  the  most  notable  being  Scheviningeu. 

The  resorts  on  the  coast  lyiug  nearly  opposite  the  English  shores 
have,  to  speak  generally,  an  air  which  possesses  more  dryness  and 


388  MEDICAL  CLIMATOLOGY. 

quality  of  stimulation  than  the  resorts  further  to  westward,  and  less 
equability. 

Scheviningen,  situated  on  the  coast  of  Holland,  about  three  miles 
from  the  Hague,  offers  all  the  advantages  of  a  seaside-resort,  having 
a  quaint  and  pleasing  character  quite  its  own.  It  possesses  a  good 
beach,  every  facility  for  sea-bathiug,  fair  hotel-accommodations,  and 
a  soft,  healthy,  though  not  bracing  climate.  The  wind  is  sometimes 
high,  but  rarely  sharp.  Many  pleasant  and  interesting  excursions 
may  be  taken  to  the  Hague,  to  Delft,  to  Haarlem,  and  to  Am- 
sterdam. 

Belgium 

is  somewhat  drier  and  warmer  than  Holland,  but  has  otherwise  much 
the  same  peaceful  characteristics,  and  a  few  weeks'  loitering  among 
the  quaint  old  Flemish  towns,  such  as  Bruges  and  Ghent,  with  their 
beautiful  old  buildings,  or  in  the  cheerful,  handsome  capital,  Brus- 
sels, is  pleasant  and  profitable  to  many  delicate  travellers,  while  on 
its  coasts  the  resorts  of  Ostend  and  Blankenberghe  are  attractive  to 
those  who  seek  a  sea-climate  amidst  gay  surroundings. 

Ostend  is  a  seaside-resort  with  a  magnificent  beach,  where  good 
sea-bathing  may  be  enjoyed.  The  climate  is  stimulating.  The 
popularity  and  gaiety  of  Ostend,  however,  make  it  rather  expen- 
sive and  less  valuable  to  most  health-seekers. 

Blankenberg-he,  to  the  east  of  Ostend,  has  an  even  finer  beach 
and  a  better  seaside  promenade ;  but  it  has  become,  of  late  years, 
almost  as  gay  and  expensive  a  resort. 

Spa,  situated  in  Belgium,  but  lying  close  to  the  German  frontier, 
is  a  very  favorably  known  resort,  with  a  population  of  7000  or 
more.  It  possesses  iron  springs  to  the  number  of  sixteen,  the  prin- 
cipal one  being  called  '•'  Pouhon".  An  analysis  of  sixteen  fluid  ounces 
of  the  water  of  this  spring  shows,  according  to  Dr.  Charteris,  four- 
fifths  of  a  grain  of  iron,  salts  of  sodium,  calcium,  and  magnesium, 
and  eight  cubic  inches  of  carbonic  acid  gas.  Spa  has  an  elevation 
of  over  1000  feet,  but  the  climate  is  somewhat  enerv^ating. 

The  Channel  Islands, 

which  still  belong  to  England  and  are  the  last  relics  of  the  Norman 
possessions,  are  situated  in  the  Great  Bay  of  St.  Michael.  They 
have  a  warm  winter  climate,  with  a  fine  but  humid  air,  and  are 


EUROPE.  389 

somewhat  subject  to  winds.      The  accommodations  in  Jersey  and 
Guernsey  are  good  and  the  rates  of  living  are  low. 

Jersey,  the  largest  of  these  islands,  lies  thirteen  miles  northwest 
of  France  and  thirty-five  miles  south  of  England.  Its  two  chief 
towns,  St.  Aubin  and  St.  Heliers,  are  much  frequentetl  by  invalids. 

Prance. 

It  may  be  said  of  the  French  seaside-resorts  that,  generally  speak- 
ing, the  climate  is  drier  and  sunnier  than  that  of  English  resorts  of 
the  same  character,  and  much  time  and  money  have  been  spent  in 
developing  their  natural  attractions  and  adding  artificial  ones. 

Boulog-ne-sur-Mer,  a  favorite  watering-place,  with  all  the  attrac- 
tions that  a  good  beach,  a  fine  casino  and  bath-houses,  a  good  theatre, 
and  the  diversions  of  a  resort  of  the  gayer  sort  can  oifer,  is,  as  might 
be  expected,  rather  more  expensive  than  other  watering-places  on  the 
coast,  though  very  good  accommodations  may  be  had  at  a  moderate 
price.     The  climate  is  comparatively  dry  and  bracing. 

Dieppe  is  very  similar  iu  climate  and  resources  to  Boulogne.  It 
has  iu  its  castle  and  cathedral  interesting  Norman  relics,  and  in  its 
neighborhood  is  a  very  attractive  country-side,  with  many  pictur- 
esque churches  and  ruins  to  be  found  among  its  pretty  lanes  and 
orchards. 

Btretat,  lying  between  F6camp  and  Havre,  has  a  different  aspect 
from  the  other  resorts.  It  is  situated  between  two  fine  cliffs  which 
attain  a  height  of  270  feet,  and  the  scenery  is  very  picturesque.  It 
is  a  favorite  resort  for  artists  and  authors,  whose  pictures  and  writings 
first  brought  it  into  notice.  It  has  now  excellent  accommodations 
and  a  small  casino,  and  many  pleasant  excursions  may  be  made 
through  the  beautiful  country  surrounding  the  village. 

Trouville,  originally  a  little  fishing-village,  has  become  one  of  the 
best  known  of  watering-places,  the  resort  of  all  the  fashion  and 
wealth  of  Paris.  The  season  is  during  the  summer  months.  The 
fine,  sandy  beach  is  divided  into  three  parts,  the  left  being  assigned 
to  the  use  of  ladies  only,  the  centre  to  that  of  ladies  and  gentlemen, 
and  the  right  for  the  use  of  men  exclusively.  The  accommodations 
are,  of  course,  all  that  can  be  desired,  and,  pre-eminent  in  its  line, 
stands  forth  the  magnificent  Hotel  des  Roches-Noires.  Trouville 
has  also  a  splendid  casino  and  a  good  hydropathic  establishment. 


390  MEDICAL  CLIMATOLOGY. 

Granville.  The  coast-liue  turns  southward  at  Cap  de  la  Hague, 
aud  uear  here  lies  this  seaport-town,  which  has  a  fine,  smooth  beach 
and  good  bathing. 

St.  Malo,  situated  on  a  peninsula,  is  connected  with  the  main  land 
by  a  causeway.  There  is  a  good  beach,  fiue  sea-bathing,  and  the 
location  is  adjacent  to  a  beautiful  and  interesting  section  o£  country. 
There  is  a  casino  at  St.  Malo,  and,  during  the  summer  mouths,  diver- 
sions of  various  kinds  are  provided  for  the  amusement  of  visitors. 

Dinard  lies  on  the  opposite  side  of  the  Ranee  from  St.  Malo,  aud 
a  steam-ferry  running  between  them  leaves  and  arrives  hourly. 
There  is  good  sea-bathing  here.  It  is  a  distance  of  only  ten  or 
eleven  miles  to  the  town  of  Dinan,  which  lies  amidst  the  finest 
scenic  surroundings  in  Brittany. 

On  the  coast  of  Brittany,  surrounded  by  fine  scenery,  are  Paim- 
pol,  Trequier,  and  RoscoflF.  They  lie,  however,  too  far  out  of  the 
reo-ular  tourists'  route  to  be  much  freouented.  Roscoff  has  a  climate 
noted  for  equability. 

Douarnenez,  Audierne,  Concarneau,  Le  Croisic,  Pornic,  and 
Royan  are  towns,  some  of  which  are  engaged  in  the  sardine  in- 
dustry and  all  of  which  afford  good  sea-bathing.  The  coast  near 
Audierne  is  more  exposed  to  the  Atlantic  gales ;  consequentl}^  it  is 
more  frequently  visited  by  stortns  than  the  majority  of  resorts  here. 
Concarneau  has  a  large  aquarium  aud  marine  laboratory. 

Arcachon  (latitude,  44°  1'  north),  thirty  miles  southeast  of  Bor- 
deaux and  ten  miles  from  the  coast,  is  situated  on  the  shores  of  a 
salt-water  lake,  which  is  open  only  to  the  north,  being  sheltered  on 
the  other  three  sides  by  sand-hills  covered  with  pine-woods.  It  is 
considered  to  resemble  Bournemouth.  The  Bassin  d' Arcachon,  a 
land-locked  inlet  from  the  Bay  of  Biscay,  communicates  with  the 
sea  by  a  channel  two  miles  long.  It  is  thus  perfectly  protected  from 
the  Atlantic  rollers,  aud,  as  it  has  a  gently  sloping  beach,  the  bath- 
ing is  much  safer  than  at  Biarritz. 

Biarritz  is  located  on  high  cliffs  overlooking  the  Bay  of  Biscay, 
five  miles  southwest  of  Bayonne  and  in  the  same  latitude  as  Pau, 
43°  north.  The  situation  is  much  exposed  to  gales  blowing  off  the 
Atlantic.  Biarritz  has  a  climate  resembling  that  of  places  on  the 
English  Channel,  but  warmer.  It  has  a  fine  beach  aud  surf-bath- 
ing. There  are  excellent  hotels  and  a  good  casino,  where  many 
amusements  are  provided  for  visitors,  and  the  neighborhood,  owing 


EUROPE.  391 

to  the  proximity  of  the  Pyrenees,  abounds  in  interesting  and  pleasant 
walks  and  excursions.  The  winter  season  extends  from  November 
to  March,  when  the  warm  weather  commences.  The  coast  is  rocky 
and  picturesque.  Bennet  did  not  regard  the  climate  as  equal  to  that 
of  the  Riviera,  but  it  is  bright  and  exhilarating,  botli  bracing  and 
sedative  iu  its  effects.  Yeo,  however,  tliinks  it  too  blustering  and 
humid  for  the  majority  of  chest  disorders.  The  mean  winter-tem- 
perature is  41°  to  46°;  spring,  51°  to  53°;  summer,  about  64°.  The 
relative  humidity  for  the  year  is  80  per  cent.  Annual  rainfall  about 
49  inches.  A  resident  physician,  quoted  by  Dr.  Bennet,  stated  that 
for  three  years  the  average  rainfall  from  October  to  April  was  25 
inches  on  76  days.     The  soil  is  absorbent  and  dries  quickly. 

St.  Jean  de  Luz,  located  on  the  shore  of  a  bay  a  little  to  the 
southward  of  Biarritz  and  near  the  westernmost  spurs  of  the 
Pyrenees,  has  a  situation  sheltered  by  the  surrounding  hills  from 
winds  blowing  from  the  northeast  and  southwest;  but  the  social 
atmosphere  is  duller  than  that  of  other  Pyrenean  resorts,  nor  are 
the  accommodations  so  good. 

Inland  Resorts. 

It  would  be  entirely  unnecessary,  and  within  the  limits  of  this 
book  manifestly  impossible,  to  give  full  descriptions  of  all  the 
inland  resorts  and  watering-places  in  which  France  abounds  ;  but 
it  will  be  well  to  mention  a  certain  number  of  them  to  serve  as  an 
indication  in  making  a  choice. 

Vichy,  reached  from  Paris  in  eight  and  a  half  hours  and  possess- 
ing excellent  hotels,  is  the  most  popular  of  the  French  spas.  The 
situation  is  amidst  rather  uninteresting  country,  but  everything  has 
been  done  to  render  the  place  attractive  to  visitors.  There  is  a  mag- 
nificent casino,  where  are  given  balls,  concerts,  and  good  dramatic 
performances,  and  the  arrangements  for  taking  the  waters  are  unusu- 
ally perfect.  The  springs  at  Vichy  may  be  divided  into  two  groups, 
plain  alkaline  waters  and  alkaline  iron  waters.  Bicarbonate  of  soda 
predominates  in  all  the  Vichy  springs,  and  is  by  far  the  chief  ingre- 
dient in  the  plain  alkaline  waters.  Some  of  the  springs  are  cold, 
but  the  greater  number  are  hot. 

The  climate  is  said  to  be  much  like  that  of  Paris.  Fogs  and 
thunderstorms  are,  however,  rather  frequent. 


392 


MEDICAL  CLIMATOLOGY. 


La  Grande  Grille. 

L'H5pital. 

Les  Celestins. 

Grammes. 

Grammes. 

Grammes. 

4.883 

5.029 

5.103 

0.352 

0.440 

0.315 

0.303 

0.200 

0.328 

0.003 

0.005 

0.005 

0  434 

0.570 

0.462 

ron,   0.004 

0.004 

0.004 

0.291 

0.291 

0.291 

0.130 

0.046 

0.091 

0.002 

0.002 

0.002 

0.534 

0.518 

0.534 

0.070 

0.050 

0.060 

7.914 

8.222 

8.244 

Litre. 

Litre. 

Litre. 

0.908 

1.067 

1.049 

Analyses  of  the  Three  Chief  Springs  at  Vichy. ^ 


Bicarbonate  of  soda, 
Bicarbonate  of  potash, 
Bicarbonate  of  magnesia, 
Bicarbonate  of  strontia, 
Bicarbonate  of  lime, 
Bicarbonate  of  oxide  of  iron, 
Sulphate  of  soda, 
Phosphate  of  soda, 
Arseniate  of  soda. 
Chloride  of  sodium. 
Silicic  acid, 


Free  carbonic  acid, 

The  amount  of  common  salt  (chloride  of  sodium)  gives  the 
waters  their  pungent  taste. 

Royat-les-Bains,  situated  a  little  to  the  southwest  of  central 
France,  in  the  department  of  Puy  de  Dome,  has  an  elevation  of 
1380  feet  above  sea-level.  The  waters  contain  some  lithia  and  a 
little  arsenic.  There  is,  as  is  usual  at  French  spas,  every  possible 
arrangement  for  using  the  waters,  and  K-oyat  has  a  hydropathic 
establishment,  so  that  patients  may  go  through  a  regular  water- 
cure.  The  use  of  the  water  is  prescribed  for  gouty  and  rheumatic 
affections  and  glandular  enlargements.  The  soil  on  which  Royat 
stands  is  volcanic  and  porous. 

As  to  the  climate,  sudden  storms  of  wind  and  rain  are  not  rare, 
but  the  atmosphere  is  dry,  and  there  is  much  sunshine. 

Mont  Dore-les-Bains  lies  in  central  France,  at  an  elevation  of 
3400  feet  above  the  sea,  and  is  also  within  the  boundaries  of  the 
Puy  de  Dome.  The  situation  is  good,  the  surroundings  are  beauti- 
ful and  picturesque,  and  many  interesting  excursions  may  be  made 
through  the  neighborhood,  but  the  accommodations  at  Mont  Dor6 
by  no  means  equal  those  at  Royat.  There  is  a  large  etablissemeut 
des  bains  and  an  etablissemeut  des  vapeurs,  also  extensive.  The 
springs  at  this  spa  are,  to  quote  Dr.  Yeo,  but ''  feebly  mineralized  "; 
the  waters  are  alkaline,  and  the  main  ingredients  are  bicarbonates 
of  soda  and  potash  and  chloride  of  sodium.     They  have  a  tempera- 


1  Yeo's  Climate  and  Health-resorts. 


EUROPE. 


393 


tare  of  107°  to  115°  F.,  are  used  for  both  drinking  and  bathing, 
and  are  taken  in  cases  of  lumbago,  sciatica,  intercostal  neuralgia, 
rheumatism,  and  throat  affections. 

La  Bourboule  lies  at  a  distance  of  five  miles  from  Mont  Dore, 
and  has  an  elevation  of  2850  feet.  The  waters,  which  have  a  tem- 
perature of  140°  F.,  are  saline,  effervescent,  and  arsenical,  and  are 
efficacious  in  cases  of  chronic  skin-diseases  and  in  rheumatism. 
They  are  used  for  drinking  and  bathing.  There  are  the  usual 
establishments  for  the  application  of  the  waters,  a  large  swimming- 
bath  and  a  fine  casino,  and  many  delightful  excursions  may  be  taken 
from  here  through  the  beautiful  surrounding  country. 

Aix-les-Bains,  in  the  province  of  Savoy,  has  an  elevation  of  850 
feet,  and  is  prettily  situated.  The  climate  is  mild  and  equable, 
though  the  summer  heat  is  sometimes  great.  The  springs  are  sul- 
phurous, the  chief  element  being  sulphuretted  hydrogen,  and  their 
temperature  ranges  from  110°  to  115°  F.  The  waters  are  used  for 
both  drinking  and  bathing,  and  for  the  latter  mode  of  application 
the  arrangements  are  very  perfect.  There  are  also  rooms  for  in- 
haling the  sulphurous  vapors  and  the  spray  of  the  waters.  The 
season  is  during  the  summer,  but  the  thermal  ^tablissement  is  open 
during  the  entire  year.  The  place  is  resorted  to  by  sufferers  from 
rheumatism  and  gout  and  from  some  forms  of  chronic  catarrh.  The 
hotels  are  excellent,  and  there  is  a  fine  casino.  It  enjoys  a  great 
vogue  with  the  fashionable  world,  and  may  perhaps  be  regarded 
to-day  as  the  most  important  of  the  French  spas. 

Analyses  of  Two  Springs  at  Aix-les-Bains  according  to 

VlNTRAS  AND   BrACHET.'^ 

Source  de  Soufre. 


Source  d'Alun  ou  de  St.  Paul. 


Calcic  carbonate, 
Magnesic  carbonate, 
Ferric  carbonate, 
Calcic  sulphate, 
Magnesic  sulphate, 
Sodic  sulphate, 
Aluminic  sulphate, 
Sodic  chloride. 

Silica,  calcic  phosphate  in  minute  quantities, 
iodine  ;  also  some  organic  matter  (baregine). 


Vintras. 

Brachet. 

Vintras. 

Brachet. 

0.1485 

0.1894 

0.18100 

0.1623 

0.02587 

0.0105 

0.01980 

0.0196 

0.00886 

0.0010 

0.00936 

0.0008 

0.01600 

0.0928 

0.01500 

0.0810 

0.03527 

0.0735 

0.03100 

0.0493 

0.09602 

0.0327 

0.09240 

0.0545 

0.05480 

0.0081 

0.06200 

0.0003 

0.00792 

0.0300 

0.01400 

0.0274 

and  traces  of  lithium  and 


^  Yeo's  Climate  and  Health-resorts. 


394  MEDICAL  CLIMATOLOGY. 

Pau  (latitude,  43°  17'  north;  elevation,  620  feet),  an  inland  town, 
noted  for  the  stillness  of  the  air,  where  "a  plentiful  amount  of  rain 
falls  perpendicularly."  It  is  finely  situated  on  a  high  ridge  over- 
looking the  chain  of  the  Pyrenees — twenty-five  miles  distant.  The 
mean  winter-temperature  is  42°  F.  The  annual  amount  of  rainfall 
is  43  inches.  There  are  119  rainy  days.  The  stormy  season  is  in 
September,  October,  and  November.  The  climate  is  cold  and  sedative. 
There  are  beautiful  promenades  and  good  accommodations  for  visitors. 

Bareges,  lying  at  an  elevation  of  4000  feet  above  sea-level,  is 
not  well  situated,  but  is  rich  in  mineral  springs.  There  are  twelve 
of  these,  ranging  in  temperature  from  88°  to  113°  F. ,  and  the 
waters  are  used  for  both  drinking  and  bathing.  Its  sulphur  waters, 
among  the  strongest  existing  in  the  Pyrenees,  abound  in  a  nitro- 
genous substance  to  which  has  been  given  the  name  of  baregine. 
There  is  a  hospital  for  soldiers,  and  one  for  nuns  and  priests  at 
Bareges.  The  climate  is  very  variable,  and  the  place  is  subject  to 
cold  mists  and  strong  winds. 

Cauterets  is  not  fashionable  like  Luchon,but  is  much  patronized 
by  invalids  who  intend  to  make  a  business  of  getting  well.  It  has 
an  elevation  of  3000  feet,  but  the  climate  is  rainy,  subject  to  sudden 
changes,  and,  on  account  of  the  very  sheltered  situation  of  the 
place,  not  particularly  bracing.  Entirely  surrounded  by  lofty 
mountains,  it  is  apt  to  be  hot  and  sultry  in  the  middle  of  the  day, 
though  the  mornings  and  evenings  are  usually  fresh  and  cool. 
There  are  many  mineral  springs  at  Cauterets,  used  for  drinking 
and  bathing,  and  the  bathing-establishments  have  every  appliance 
for  the  use  of  the  waters,  which  are  of  the  sulphurous  saline  variety 
and  have  a  temperature  ranging  from  55°  to  145°  F. 

Bag-neres-de-Luchon,  lying  in  the  Pyrenees,  near  the  Spanish 
frontier,  has  an  elevation  of  1900  feet.  There  are  about  fifty  sul- 
phur springs  here  and  some  chalybeate  waters.  It  is  a  very  much 
patronized  resort,  and  has  most  excellent  bathing-establishments. 
In  fact,  the  features  of  Luchon  are  beauty  and  luxury.  The  waters 
are  taken  for  skin-diseases,  scrofula,  and  rheumatism.  It  has  a 
mild  climate,  but  during  the  months  of  May,  June,  and  September 
the  air  is  quite  fresh  and  bracing. 

Spain 

is  generally  too  warm  for  summer,  and  the  accommodations  and 
methods  of  travel   do    not    make  it   attractive  to  the  delicate   or 


EUROPE.  395 

refined  tourist.  There  are,  however,  some  resorts  in  the  Pyrenees 
and  some  on  the  Mediterranean  coast  which  possess  good  climates 
and  certain  advanta(j;es.  Of  the  latter,  Malao^a  is  the  most  fre- 
quented. 

San  Sebastian  and  Gijon  lie  on  the  northeastern  coast.  San 
Sebastian  is  used  as  a  winter-resort,  and  the  situation  is  both  beau- 
tiful and  protected.  Because  of  the  latter  characteristic  and  of  its 
mild  climate  it  might  be  a  suitable  resort  for  patients  who  have 
lung-troubles,  but  in  the  absence  of  exact  informatiou  it  is  impos- 
sil)le  to  make  positive  assertions. 

Malaga  is  one  of  the  mildest  climates  on  the  Spanish  shores  of 
the  Mediterranean.  It  is  well  sheltered,  warm,  moderately  moist, 
and  slightly  stimulating.  The  mean  winter-temperature  is  56°  F. 
The  heat  becomes  intense  early  in  the  spring.  Rainfall  for  the  year, 
16^^  inches  on  40  rainy  days.  Dr.  C.  T.  Williams  refers  to  this 
climate  as  being  warmer  and  "drier"  than  the  Riviera,  and  it  has 
apparently  a  smaller  daily  aud  seasonal  range.  ^  The  great  drawback 
has  always  been  the  lack  of  suitaole  accommodations  for  invalids, 
especially  in  the  shape  of  suburban  villas  and  hotels  away  from  the 
densely  populated  and  poorly  drained  town.  It  is  picturesque  and 
bright. 

Panticosa,  a  Spanish  spa  lying  on  the  southern  slopes  of  the 
Pyrenean  range,  at  an  elevation  of  about  5000  feet,  is  said  to  be 
very  suitable  to  phthisical  cases.  It  possesses  mineral  waters  of  no 
great  streugth  but  containing  a  considerable  amount  of  nitrogen 
and  of  sulphuretted  hydrogen,  and  having  a  temperature  of  77°  to 
91.4°  F.  It  is  customary  to  drink  from  twenty  to  thirty  glasses 
of  this  water  daily.  Little  exact  information  in  regard  to  this 
resort  can  be  obtained. 

Seville,  interesting  as  a  city,  likewise  offers  to  the  health-seeker 
the  advantages  to  be  derived  from  a  warm,  sunny,  usually  dry 
climate.  Ice  and  snow  are  said  never  to  exist  here.  The  hotel- 
accommodation  is  good. 

Portugal. 

Among  the  cities  of  Portugal  the  two  large  commercial  ports, 
Oporto  and  Lisbon,  on  the  shores  of  the  Atlantic,  are  somewhat 
used  as  health-resorts  by  those  whose  chief  desideratum  in  a  climate 

1  Aerotherapeutics. 


396  MEDICAL  CLIMATOLOGY. 

is  mildness,  but  the  country  generally,  like  that  of  Spain,  is  lacking 
in  resources  for  the  comfort  of  foreigners. 

The  Riviera. 

Certain  parts  of  France  and  Italy  have  usually  been  treated  under 
the  comprehensive  name  of  the  Riviera,  and  both  countries  possess 
resorts  characterized  by  the  climatic  conditions  peculiar  to  this 
district.  It  has,  therefore,  seemed  better  to  the  author  to  follow  the 
established  custom  of  treating  such  resorts  under  this  head  than  to 
describe  each  place  with  others  in  the  country  iu  which  it  belongs. 

The  temperature  of  the  Riviera  during  the  winter  is  not  usually 
more  than  8°  or  10°  F.  warmer  than  the  south  coast  of  England^ 
but  it  is  less  moist  and  more  stimulating,  and  compared  with  the 
English  coast  the  Riviera  has  half  the  number  of  rainy  days  and 
four  or  five  times  the  number  of  bright  ones. 

Dr.  Williams^  has  well  and  accurately  described  this  region.  He 
refers  to  the  entire  coast  as  having  a  mean  winter-temperature  of  50° 
or  51°  F. ,  the  minimum  of  42°  to  46°  being  reached  in  December. 
Occasionally  it  sinks  to  the  freezing-point,  and  snow  sometimes  falls. 
A  feature  of  the  climate  is  the  rapid  fall  of  temperature  after  sunset, 
especially  at  any  distance  from  the  sea.  The  relative  humidity  varies 
from  61  to  74  per  cent.  The  rainfall  is  generally  31  inches.  A 
rainy  season  occurs  in  October  and  November  and  again  during 
the  latter  half  of  March.  The  rainfall  increases  eastward  on  the 
Riviera  and  diminishes  westward.  The  principal  winds  are  the 
northwest  or  '' mistral,"  a  steady,  cold,  and  dry  wind,  prevailing 
chiefly  in  March  and  much  dreaded,  although  it  usually  brings  fine 
weather  ;  the  northeast  or  ''  bise,"  a  cold  wind  ;  and  the  southeast 
or  ^'sirocco,"  a  warm,  enervating  one.  The  westerly  winds  are 
dry  and  the  easterly  moist,  the  opposite  of  what  prevails  in  Great 
Britain  and  Ireland.  The  amount  of  lime  in  the  soil  renders  the 
dust  in  the  more  windy  places,  like  Hyeres  and  Nice,  quite  objec- 
tionable. The  winter  climate  of  the  Riviera  is  clear  and  bright, 
with  a  good  deal  of  wind,  but  devoid  of  fog  or  mist.  The  influ- 
ence of  the  sea-air  in  rendering  the  air  moist  is  not  usually  strongly 
marked,  on  account  of  the  prevalence  of  land-winds. 

Dr.  J.  Henry  Bennet  warns  the  visitor  to  the  Riviera  not  to  ex- 
pect an  absence  of  winter.      It  is  only  a  retreat  affording  a  certain 

1  Aerotherapeutics ;  being  the  Lumleian  Lectures  lor  1893.    C.  T.  Williams,  1894. 


EUROPE.  397 

local  protection  in  the  warmer  temperate  zone.  He  says:  ''The 
descriptions  of  the  winter  climate  of  Nice,  Cannes,  Hyeres,  and 
Italy  in  general  contained  in  most  books  of  travel,  works  on  climate, 
and  guide-books,  are  mere  poetical  delusions.  The  perpetual  spring, 
the  eternal  summer,  the  warm  southern,  balmy  atmosphere,  described 
to  the  reader  in  such  glowing  terras,  only  exist  in  the  imagination 
of  the  writers.  Although  there  is  so  much  sunshine,  so  much  fine 
weather,  such  immunity  from  fog  and  drizzling  rain,  it  is  still  the 
continent  of  Europe,  with  ice  and  snow  behind  for  more  than  a 
thousand  miles,  to  the  North  Pole.  It  is  still  winter.  Wind,  rain, 
a  chilly  atmosphere,  and  occasional  cold  weather,  with  snow  on  the 
mountains  and  flakes  of  ice  in  exposed  situations,  have  to  be  en- 
countered. .  .  .  The  existence  of  orange  and  lemon  trees,  of 
geraniums,  heliotropes,  verbenas,  and  roses,  flowering  throughout 
the  winter,  does  not  necessarily  imply  the  absence  of  cold  weather, 
but  merely  the  absence  of  absolute  frost."^ 

The  French  Riviera. 

Hyeres  is  situated  three  miles  from  the  sea,  which  makes  it  some- 
what less  stimulating  to  nervous  people.  It  has  a  climate  said  to 
be  warmer  than  that  of  Nice.  The  minimum  (or  night)  tempera- 
ture for  Hyeres  is  29°  and  for  Nice  27°  F.-^  The  mean  mid- 
day temperature  for  Hyeres  for  winter  is  52°  and  for  spring  63°. 
A  record  for  twenty-six  years,  quoted  by  Dr.  C.  E.  Cormack,  of 
Hyeres,  shows  the  average  number  of  rainy  days  for  the  eight 
months — October  to  May — to  be  36  days  as  against  Nice  51, 
Cannes  54,  and  Mentone  64  days.  The  average  number  of  rainy 
days  for  Hyeres  for  winter  is  14  and  for  spring  11.  The  usual 
number  of  stormy  days  for  each  month  may  be  considered  as  4. 
The  wettest  months  are  October  and  December  and  the  finest  month 
March.  Much  of  the  rainfall  occurs  at  night.  The  greatest  record 
of  rainfall  in  one  year  is  52  inches  and  the  smallest  15  inches — a 
mean  of  SS^  inches.  Snow  falls  perhaps  once  in  three  years,  but 
seldom  remains  more  than  an  hour  or  two.  There  are  occasionally 
light  frosts  at  night.  The  prevailing  winds  at  Hyeres  in  the 
winter  are  from  the  north,  northeast,  and  northwest  (the  mistral), 
while  iu  the  spring  they  are  from  the  east,  southeast,  or  northeast. 

1  For  comparison,  see  Santa  Barbara  ;  Table  XIV. ;  and  Tables  V.-X. 

3  The  French  Riviera.    Charles  Cormack,  in  the  Climatologist,  January,  1892. 


398  MEDICAL  CLIMATOLOGY. 

The  winter-winds  are  sometimes  quite  violent.  Hyeres  is  favored 
with  good  hotels. 

Cannes  is  prettily  situated  in  a  recess  of  the  Gulf  of  Napoule. 
It  is  sheltered  to  the  north  and  northeast,  and  to  some  extent  to 
the  northwest.  On  the  east  and  south  it  is  exposed.  It  has  an 
annual  mean  temperature  of  60°  F.,  with  an  average  for  the  winter 
mouths  of  50°  and  for  the  spring  of  62°.  January  is  the  coldest 
month.  The  prevailing  wind  is  from  the  east  and  southeast.  The 
annual  rainfall  is  25  inches.  The  annual  number  of  rainy  days  in 
Cannes  is  54.  It  is  a  fashionable  resort,  with  superior  accommoda- 
tions. 

Nice  (population,  90,000)  has  an  annual  mean  temperature  of 
59°  F.  The  mean  for  winter  is  47°  and  for  spring  56°.  The 
relative  humidity  during  the  winter  is  QQ  per  cent.,  and  in  the  spring 
68  per  cent.  The  annual  rainfall  is  32  inches  on  60  rainy  days. 
Nice  is  a  southern  capital,  with  its  Italian  opera  and  French  theatre, 
its  daily  fashionable  promenade  and  drive,  its  military  band,  and  its 
swarm  of  gaily  dressed  people.'  It  is  comfortably  convenient  to 
Monte  Carlo.  The  city  is  situated  on  the  verge  of  a  valley,  sur- 
rounded on  three  sides  by  the  Maritime  Alps  and  open  on  the  other, 
or  south  side,  to  the  Mediterranean.  Dr.  Madden,  of  Dublin,  refers 
to  the  climate  as  warm,  dry,  tonic,  and  exciting.^ 

The  average  mean  temperature  is  a  little  higher  than  at  Cannes. 

Mentone,  twenty-three  miles  from  Nice,  can  be  reached  by  ex- 
press from  Paris  in  twenty-two  hours.  It  has  a  warm,  equable 
climate,  and  is  exempt  from  harsh,  cold  winds.  It  is  one  of  the 
least  dry  resorts  on  the  Riviera,  because  so  much  of  the  dry  land- 
wind  is  kept  away  by  the  neighboring  elevations.  It  has  an  annual 
mean  temperature  of  60°  F. ;  a  temperature  for  winter  of  49°  and 
for  spring  of  60°.  The  relative  humidity  for  the  year  averages  72 
per  cent.  The  Mentone  amphitheatre  is  better  protected  than  other 
portions  of  the  Riviera  by  mountains,  and  to  this  is  due  the  locally 
warm  climate.  Its  lemon-groves  are  only  equalled  in  localities 
much  further  south.  The  nights  are  usually  chilly,  the  thermome- 
ter reading  46°  to  54°  F.  with  south  winds,  and  with  winds  from 
the  north,  which  are  drier,  ranging  from  40°  to  45°,  or  even  lower 
than  40°  between  December  and  April.  In  the  daytime  the  shade- 
temperature  is  50°  to  56°  when  the  sun  shines.     For  invalids  north 

1  Winter  in  the  South  of  Europe.    J.  Henry  Bennet,  London,  1S65. 
For  comparison  with  the  coast  of  Soutliern  California,  see  Santa  Barbara. 


EUROPE.  399 

rooms  are  to  be  avoided,  as  they  are  4°  to  8°  colder  than  south 
rooms.  The  rainy  days  come  between  October  and  May.  Dr. 
Benuet  notes  29  rainy  days  duriug  the  four  months  December  to 
March.  But  Httle  rain  falls  during  the  summer.  The  amount  of 
annual  rainfall  is  not  obtainable,  but  it  is  undoubtedly  greater  than 
at  i^ice,  as  there  are  at  Mentone  during  the  year  an  average  of  80 
rainy  days.  The  severest  rains  usually  come  during  the  months  of 
October,  November,  and  March. 

The  water-supply  for  domestic  use  should  be  boiled  as  a  necessary 
safeguard. 

Hotel  charges  and  the  cost  of  housekeeping  in  Mentone  are  high. 

The  Italian  Riviera. 

Bordig-hera,  the  first  resort  beyond  the  Italian  boundary,  is 
sunny,  but  more  exposed  than  the  eastern  part  of  Mentone.  It  has 
a  fine  growth  of  palm-trees. 

San  Remo  is  fifteen  miles  further  from  Nice  than  Mentone,  and 
is  less  picturesque,  but  has  a  similar  climate.  The  town  is  larger 
than  Mentone  and  thoroughly  Italian.  It  faces  southwest  on  a 
beautiful  bay.  It  is  well  protected  by  encircling  mountains  from 
the  most  severe  north  and  east  winds.  The  season  is  from  Novem- 
ber 1st  to  April  30th.  The  mean  shade-temperature  for  that  period 
for  eleven  years  is  reported  by  Dr.  Hassall  to  have  been  53°  F. 
For  the  three  months  of  winter  it  was  48°.  Freezing-point  was 
usually  reached  once  during  each  season.  The  mean  seasonal  rela- 
tive humidity  was  70  per  cent.  The  average  seasonal  rainfall  was 
16  inches,  distributed  over  34  rainy  days.  Since  the  completion  of 
the  new  aqueduct  the  drinking-water  of  San  Remo  is  considered 
excellent. 

Along  the  entire  Riviera,  from  Hyeres  to  Spezia,  are  a  number  of 
small  towns  with  various  natural  advautages,  in  some  cases  as  great 
as  the  more  famous  resorts,  although  the  shelter  of  the  mountains  is 
less  complete  at  the  eastern  end.^ 

Genoa,  with  a  climate  neither  warm  nor  equable  and  subject  to 
frequent  rains  and  winds,  can  in  no  sense  be  characterized  as  a 
health-resort,  but  it  is  in  many  ways  an  interesting  town,  and  is  the 
terminus  of  a  voyage  taken  by  means  of  the  North  German  Lloyd 
steamers  from  New  York  across  the  Atlantic  and  through  Mediter- 

1  Dr.  Rohden  on  Climatic  Health-resorts,  in  Braun's  work  on  Balneology. 


400  MEDICAL  CLIMATOLOGY. 

raneau  waters,  which  is  most  delightful  and  which  may  be  extremely 
beneficial.  The  ships  are  comfortable  and  well-found,  so  that  the 
daily  life  of  the  passengers  is  under  favorable  auspices,  and  the  con- 
ditions are  very  suitable  to  those  who  are  suffering  from  overwork 
or  to  invalids  whose  general  condition  is  good,  especially  if  sea-sick- 
ness is  not  greatly  to  be  feared. 

Peg-li  and  Nervi,  near  Genoa,  are  quiet,  well-sheltered  places,  and 
have  good  hotels ;  but  too  little  attention  has  as  yet  been  given  to 
the  requirements  of  invalid  life  to  recommend  them  highly  for  the 
more  delicate  class  of  patients.  Nervi  has,  during  the  mouths  from 
November  to  April,  a  rainfall  of  252^  inches,  distributed  through 
fifty-four  or  more  rainy  days. 

Spezia,  a  town  of  about  20,000  inhabitants,  has  a  mild  climate, 
rather  moist  and  fairly  equable,  and  the  air  is  free  from  dust. 
There  is  every  facility  for  sailing,  boating,  aud  ridiug.  The  town 
is  situated  upon  a  gulf,  the  west  coast  of  which  is  rugged;  but  the 
northern  and  eastern  borders  are  lower  and  allow  of  walking  and 
driving.     The  hotels  are  spacious  and  comfortable. 

Islands  of  the  Mediterranean. 

Corsica  is  about  115  miles  in  length  and  54  miles  wide  at  its 
broadest  point.  It  is  90  miles  from  the  coast  of  France  and  about 
54  miles  from  Italy.  The  island  is  a  mass  of  Alpine  mountain- 
ridges  rising  out  of  the  sea.  In  the  centre  the  principal  range 
rises  to  a  height  of  8000  or  9000  feet.  The  eastern  coast  is  marshy 
and  unhealthy,  but  the  climate  of  the  western  coast  is  healthy.  The 
season  extends  from  the  last  of  October  to  June. 

Ajaccio  (latitude,  41°  55'  north)  has  some  repute  as  a  winter- 
resort,  and  is  a  ''clean  and  smiling  little  French  town";  it  is 
situated  on  the  northwest  side  of  a  picturesque  bay.  Twenty 
miles  inland  is  a  semicircle  of  mountains  rising  to  6000  and  9000 
feet,  the  highest  peaks  of  which  are  covered  with  snow  even  in 
summer.  There  is  a  marked  absence  of  the  strong  winds  that 
usually  prevail  on  the  Mediterranean  in  winter,  although  there  is  a 
regular  sea-breeze  during  the  day  aud  a  land-breeze  at  night. 

Dr.  J.  Henry  Benoet  says  :  "  The  vegetation  of  Ajaccio  and  the 
neighborhood  indicates  a  climate  at  least  as  warm  as  that  of  Nice, 
perhaps  even  a  shade  warmer.  The  olive,  the  orange,  the  prickly 
pear,  thrive  with  great  luxuriance.     The  lemon  grows  also,  an(J 


EUROPE.  401 

beans  fruit  outdoors,  hut  only,  as  in  Nice,  in  sheltered  and  protected 
spots.'" 

Dr.  Bennet  considers  Ajaccio  as  the  best  town  on  the  island  for  a 
winter-residence. 

There  are  mineral  baths  at  Guagno,  twenty  miles  northeast  of 
Ajaccio,  and  the  water  of  a  fine  sparkling  chalybeate  spring  at 
Orezza,  thirty  miles  south  of  Bastia,  is  bottled  for  the  market. 

Dr.  Hermann  Weber,  of  London,  spent  the  winter  of  1895  in 
Ajaccio,  and,  in  a  private  letter,  states  that  he  considers  it  a  good 
place  for  invalids  requiring  a  moderately  warm  winter,  as  it  pos- 
sesses a  climate  less  dry  and  exciting  than  that  of  the  Riviera. 
There  are  pleasant  walks  among  the  olive-trees  and  pines.  There 
is  a  good  hotel.  Steamers  go  from  Nice  and  Marseilles  in  from 
fourteen  to  twenty  hours.  They  are  small  boats,  and  far  from 
comfortable  in  rough  weather. 

Corfu.  This  island  is  reached  by  steamer  from  Brindisi  or  Trieste 
and  lies  near  the  coast  of  Albania,  from  which  it  is  separated  by  the 
strait  known  as  the  Channel  of  Corfu.  It  is  picturesque  and  inter- 
esting, is  traversed  by  very  good  roads,  and  affords  many  pleasant 
excursions,  and  the  hotel-accommodations  are  good.  The  winter 
climate  is  not  equable,  nor  is  the  place  free  from  fogs  and  cold 
winds,  thouo-h  the  wind  from  the  southeast  is  said  to  be  unpleas- 
antly  enervating,  but  there  is  little  dust.  The  mean  temperature 
for  January  and  February  is  50°  F.  or  thereabout,  and  for  April  it 
is  60°,  and  the  mean  relative  humidity  ranges  between  70  and  80 
per  cent.  The  rainfall  is  large,  and  there  are  from  November  to 
April  about  72  rainy  days. 

Malta  (latitude,  35°  54'  north)  cannot  be  said  to  present  many 
advantages  to  the  health-seeker.  Its  appearance  is  barren,  its 
accommodations  (outside  the  two  hotels  in  Valetta  and  its  suburb, 
Sliema)  are  poor,  the  possibilities  for  the  daily  life  of  an  invalid 
limited  and  unsuitable,  and  the  climate,  while  equable,  sunny,  and 
moderately  dry,  is  relaxing.  It  is  true  that,  as  it  has  nowhere  a 
greater  elevation  than  600  feet,  the  great  exposure  of  Malta  to  winds 
may  somewhat  counteract  this  relaxing  tendency ;  but  the  remedy, 
like  the  disease,  has  its  disadvantages.  Fever  appears  to  be  rather 
prevalent.      Of  course,  here  as  elsewhere,  there  is  a  great  difference 

I  Winter  in  the  South  of  Europe.    J.  Henry  Bennet,  M.D. 
26 


402  MEDICAL  CLIMATOLOGY. 

between  seasons,  and  during  a  fine  autumn  the  author  found  Malta 
very  pleasant. 

The  climate  is  remarkably  equable,  the  night  and  day  tempera- 
tures varying  little  more  than  5°  in  winter  and  only  8°  in  summer. 

The  mean  annual  temperature  is  65.95°  F.  Winter-temperature, 
55.99°;  spring,  61.18°;  summer,  76.17°;  autumn,  70.44°. 

The  annual  rainfall  is  23.93  inches,  of  which  two-thirds  fall  in 
the  winter.  The  influence  of  the  sirocco  is  sometimes  felt,  and  it 
is  apt  to  be  windy. 

A  short  stay  at  Malta  during  tiie  winter  may  be  beneficial  to  an 
invalid  of  the  robuster  sort,  and  the  place  affords  all  the  gaiety 
and  amusement  consequent  upon  its  being  an  important  garrison- 
town. 

Sicily.  The  chief  town  of  Sicily,  Palermo,  possesses  a  climate  not 
subject  to  sudden  change.  Tlie  mean  winter-temperature  is  about  54° 
F.,  but  the  winter  climate  is  moist  as  well  as  warm.  The  city  is  hand- 
somely built,  and  its  situation,  opposite  the  bay  and  surrounded  by 
mountains,  is  incomparably  fine.  According  to  Dr.  Yeo,  Palermo, 
as  compared  with  Nice,  has  131  rainy  days  to  60 ;  but  the  rainfall, 
on  the  contrary,  is  only  21  inclies  to  25  inches  at  Nice.  The  Afri- 
can sirocco  occasionally  blows  over  the  island,  and,  while  its  warmth 
probably  serves  to  raise  the  temperature,  its  effects  are  bad,  render- 
ing the  air  dry  and  irritating, 

Catania  and  Aci  Reale,  which  have  also  been  recommended  as 
health-resorts  in  Sicily,  need  but  a  short  notice.  The  climates  are 
rather  similar.  The  mean  winter- temperature  of  Catania  is  53.8°  F. 
and  the  daily  range  in  temperature  is  about  14.5°.  The  tempera- 
ture at  night  is  much  lowered,  owing,  it  is  said,  to  the  snow-fields 
of  Mount  Etna,  the  town  being  situated  at  the  foot  of  the  volcano. 
Aci  Reale  has  mineral  springs  and  a  fine  bathing-establishment,  and 
its  elevation  is  greater  than  that  of  Catania,  affording  a  fresher, 
purer  air.     The  hotels  in  both  towns  are  said  to  be  good. 

Italy. 
Coast  Resorts. 

Sorrento  is  delightfully  situated  opposite  the  beautiful  island  of 
Capri.  In  the  spring  it  is  resorted  to  by  pulmonary  invalids,  and 
in  May  and  June  there  is  sea-bathing. 


EUROPE.  403 

Castellamare  di  Stabia,  sitiuited  on  the  south  shore  of  the  Bay 
of  Naples,  is  used  as  a  health-resort  during  the  fall  and  winter  sea- 
sous.  It  possesses  saliue  waters,  contaiuino-  also  a  small  quantity 
of  iron.  On  account  of  its  climate  it  is  resorted  to  by  phthisical 
invalids,  and  its  mineral  waters  are  said  to  be  useful  in  cases  of 
calculi,  disorders  of  the  liver  accompanied  by  dropsy,  and  so  forth. 

Ischia,  an  island  in  the  Bay  of  Naples,  has  alkali -saliue  waters, 
whose  temperature  is  145°  F,  There  were  formerly  extensive  bath- 
ing-arrangements, but  many  of  the  establishments  were  destroyed 
by  the  earthquake  of  1883. 

Naples  has  a  dry,  mild  winter  climate,  and  is  still  a  little  used 
as  a  resort  at  that  season.  It  possesses  many  different  kinds  of 
mineral  springs.  The  city,  though  dirty,  is  attractive,  aud  the 
surrounding  scenery  is  most  beautiful.  The  hotels  are  good  and 
excursions  through  the  environs  are  very  interesting. 

Inland  Resorts. 

Rome  is  too  well  known  to  need  more  than  the  briefest  mention. 
As  a  health-resort  its  reputation,  which  was  at  one  time  great,  is  on 
the  wane.  The  mean  winter-temperature  is  from  45°  to  50°  F., 
but  the  air  is  not  so  dry  as  that  of  the  Riviera.  Dr.  Charteris  very 
sensibly  says  that  medical  advice  should  always  be  taken  before 
deciding  on  winter-quarters  in  Rome  because  of  the  prevalence  of 
fevers  in  certain  localities. 

Lucca,  in  Tuscany,  is  situated  on  a  hillside  with  good  shade-trees 
about  it.  There  are  sulphate  of  lime  waters  with  a  temperature 
raneina:  from  70°  to  125°  F.,  which  are  said  to  be  efficacious  in  cases 
of  rheumatism  and  gout  and  in  skin-diseases.  There  are  adequate 
arrangements  for  receiving  and  caring  for  invalids,  and  the  climate 
is  agreeable. 

The  Italian  Lakes.  On  the  shores  of  these  lakes  one  finds 
charming,  cool,  moist  summer  climates,  with  beautiful  scenery  and 
good  accommodations.  The  climate  is  much  influenced  by  the 
proximity  of  the  Alps,  which  render  them  too  hot  in  summer  and 
too  windy  in  winter ;  but  there  are  several  places  whose  chief 
recommendation  to  invalids  is  that  they  make  good  resting-places  in 
the  spring  and  autumn  for  those  who  are  journeying  to  or  from  the 
winter-  or  summer-resorts  of  Italy,  the  Riviera,  and  Switzerland. 
Among  them  may  be  mentioned  : 


404  MEDICAL  CLIMATOLOGY. 

Lugano,  ou  l^ake  Lugano  (elevation,  900  feet).  Pretty  situation 
and  good  accommodations. 

Pallanza,  ou  Lake  Maggiore  (elevation,  600  feet).  Good  climate 
and  capital  arrangements  for  the  reception  and  care  of  invalids.  The 
hotel  is  open  during  the  winter  months. 

Cadenabbia.  Good  place  to  avoid  the  ill-effects  of  the  seasonal 
changes  of  spring  and  fall. 

Bellagio,  on  Lake  Como,  one  of  the  most  noted  of  these  resorts, 
is,  during  the  summer  and  autumn,  a  favorite,  but  not  a  well-chosen 
spot  for  those  who  suffer  from  pulmonary  troubles.  It  is  beauti- 
fully situated  and  has  a  delightful  climate. 

Santa  Caterina,  lying  5700  feet  above  sea-level,  has  a  most 
charming  situation.  It  is  on  the  southern  slopes  of  the  Alps,  and 
its  climate  is,  therefore,  less  stimulating  than  that  of  the  Eugadine 
resorts.  It  possesses,  however,  a  strong  iron  spring,  and  this,  com- 
bined with  the  elevation  of  the  resort,  makes  it  particularly  suitable 
for  anaemic  patients. 

Austria. 

Trieste,  ou  the  shore  of  the  Adriatic,  beside  being  a  large  seaport- 
town,  is  used  during  the  summer  months  by  those  who  wish  to  enjoy 
good  bathing  on  a  fine  beach.  The  hotels  are  good  and  the  prices 
of  living  by  no  means  exorbitant. 

Teplitz,  one  of  the  oldest  of  spas,  has  been  resorted  to  for  over 
1100  years.  It  is  situated  in  a  good-sized  valley,  surrounded  by 
granite  hills,  and  may  be  reached  from  Carlsbad  by  rail  in  three 
hours.  It  has  a  thermal  spring,  the  waters  having  a  temperature  of 
from  98°  to  120°  F.  They  are  used  chiefly  for  bathing,  and  are 
supposed  to  be  good  for  all  troubles  resulting  from  gout. 

Carlsbad,  although  it  lies  in  the  valley  on  both  sides  of  the  river 
Tepl,  has  an  elevation  of  1200  feet  above  the  sea.  The  river  is 
small  and  the  valley  narrow,  and  the  lodgings  on  the  hillsides  are 
therefore  most  desirable  as  being  cooler  and  more  breezy  than  those 
lower  down.  The  hotels  and  lodging-houses  have  no  table  d'hote, 
and  it  is  customary  to  take  one's  meals  at  the  restaurants,  where  the 
food  is  under  strict  medical  supervision.  There  is  a  fine  Kurhaus, 
with  daily  concerts  and  theatrical  performances,  but,  as  is  the  case 
at  most  of  the  gayer  resorts,  the  rates  of  living  during  the  season 
are  rather  expensive.  The  waters  have  a  temperature  of  167°  F. ; 
the   chief    ingredient   is   soda,   and   they  are   highly   charged   with 


Spradel. 

Miihlbrimuen. 

Schlossbrun. 

In  16  oz. 

In  16  oz. 

In  16  oz. 

18.21  gr. 

17.96  gr. 

17.24  gr. 

1.26 

1.71 

1.46 

7.91 

7.89 

7.52 

1045 

10.86 

9.66 

2.28 

2.02 

3.06 

0.95 

0.26 

0.38 

0.02 

0.02 

0.01 

11.80  cub.  in. 

14.80  cub.  in. 

20.60  cub.  in, 

164.2° 

125.6° 

124.7° 

EUROPE.  405 

carbonic  acid.  They  are  peculiarly  efficacious  in  cases  of  con.stipa- 
tion,  intestinal  catarrh,  hepatic  and  splenic  enlargement,  diabetes, 
etc.  A  rigorous  diet  is  imposed  upon  patients  using  the  waters. 
Below  is  given  a  table,  with  analyses  of  three  of  the  principal 
springs.  As  Carlsbad  is  one  of  the  most  famous  of  European  spas, 
it  goes  without  saying  that  the  bathing-arrangements  are  complete 
and  the  accommodations  good. 

Analyses  of  Three  of  the  Pkincipal  Springs  at  Carlsbad.' 


Sulphate  of  soda 
Sulphate  of  potash  . 
Chloride  of  sodium 
Carbonate  of  soda   . 
Carbonate  of  lime   . 
Carbonate  of  magnesia 
Carbonate  of  protoxide 

of  iron 
Carbonic  acid  . 
Temperature    . 

Marienbad,  lying  at  an  elevation  of  2000  feet,  is  in  Bohemia, 
and  is  reached  over  the  railroad  running  from  Eger  to  Pilseu. 
Its  waters  closely  resemble  those  of  Carlsbad,  but  they  are  cold. 
They  are  prescribed  for  obesity,  lack  of  digestive  power,  constipa- 
tion, chronic  dysentery,  etc.  The  principal  well  is  located  at  the 
upper  end  of  the  town,  and  is  called  the  Kreuzbrunnen.  Here,  as 
at  Carlsbad,  there  is  a  regular  diet  for  those  partaking  of  the  waters. 

Luhatschowitz,  in  Moravia,  at  an  altitude  of  600  feet,  in  the 
midst  of  interesting  and  attractive  surroundings,  possesses  alkaline, 
iodine,  and  bromine  waters,  which  are  the  strongest  of  their  kind 
known.  They  are  considered  good  in  uterine  diseases  and  scrofula. 
The  milk-cure  is  also  administered  here. 

At  Baden,  which  may  be  reached  from  Vienna  in  an  hour,  are 
found  saline  sulphurous  springs  having  temperatures  ranging  from 
82°  to  95°  F.  There  are  arrangements  for  various  kinds  of  baths. 
Baden  is  beautifully  situated  on  a  mountain-slope  and  is  surrounded 
by  pine-  and  beach-fore.sts,  and  many  delightful  and  interesting  ex- 
cursions may  be  taken  in  its  vicinity.  The  resort  is  a  fashionable 
one  and  the  accommodations  are  good. 

1  Yeo's  Climate  and  Health-resorts. 


406  MEDICAL  CLIMATOLOGY. 

Voslau,  uear  Vienna,  has  an  altitude  of  700  feet,  and  is  deliglitfully 
placed  among  hills  whose  sides  are  covered  with  vineyards.  The  cli- 
mate is  healthy  and  the  air  fresh  and  pnre.  There  are  waters  at 
Voslau  whose  temperature  is  75°  F.,  and  good  facilities  for  l)rine- 
and  pine-baths.     The  whey-  and  grape-cures  are  given  at  Voslau. 

Ischl,  situated  in  Upper  Austria,  at  an  altitude  of  1600  feet,  is 
reached  by  rail  to  Gmunden,  and  has  a  population  of  9000.  Its 
position  at  the  meeting-point  of  three  valleys,  with  an  extensive  out- 
look over  cultivated  country,  is  beautiful,  and  its  climate,  refreshing 
and  agreeable,  is  another  attraction.  The  thermometer  rarely  rises 
above  86°  F.  as  a  midsummer  temperature.  The  season  begins  in 
May  and  lasts  until  October.  The  waters,  which  are  saline  and 
sulphurous,  are  reputed  to  be  efficacious  in  nervous  affections,  chronic 
bronchitis,  etc.;  there  are  good  bathing-appliances,  including  a  large 
swimming-basin. 

"Wildbad-Gastein,  situated  uear  Salzburg,  has  springs  whose 
waters  range  from  75°  to  170°  F.  in  temperature.  They  are  said 
to  be  good  in  low  nervous  troubles  and  in  gout  and  rheumatism. 
Gastein  has  an  altitude  of  about  3000  feet.  Braun  states  that 
Gastein  resembles  Teplitz  in  everything  but  its  climatic  conditions, 
which  make  it  particularly  suitable  to  cases  complicated  by  a  much 
weakened  or  lowered  constitution  and  vitality,  requiring,  therefore, 
great  cautiousness  in  treatment. 

The  highest  temperature  which  has  been  observed  here  is  86^  F., 
and  the  climate  is  not  subject  to  sudden  or  extreme  changes  of  tem- 
perature. 

Bregenz,  on  the  east  shore  of  Lake  Constance  in  the  Tyrol,  has 
an  elevation  of  1900  feet.  It  is  a  popular  summer-resort,  and  its 
advocates  claim  that  it  is  especially  good  for  patients  suffering  from 
chest-troubles.     There  are  pine-  and  beech-woods  near  Bregenz. 

Meran,  situated  in  the  Austrian  Tyrof,  on  the  southern  slopes  of 
the  Alps,  has  an  elevation  of  1050  feet.  Except  to  the  southward, 
it  is  surrounded  by  mountains  which  rise  as  high  as  10,000  feet, 
and  its  situation  is  consequently  both  sheltered  and  picturesque.  It 
may  be  reached  by  diligence  from  Tarasp  or  by  rail  from  Inns- 
bruck ma  Botzen. 

Having  an  open  southern  aspect,  Meran  is  exposed  to  occasional 
fierce  winds  which  blow  from  that  direction,  but  the  climate  is  usu- 
ally sunny,  still,  dry,  and  not  too  warm.  There  is  an  average  of 
7    snowy    days  during  the  winter  and    of    52  rainy   days  during 


EUROPE.  407 

the  entire  year,  only  13  of  which  belong  to  the  winter  season.^ 
Mists  rarely  settle  in  the  valley.  The  medinni  winter-tem- 
perature is  41.67'^  F.,  showing  a  climate  somewhat  warmer 
than  that  of  Montreux,  but  decidedly  colder  than  that  of  Torquay, 
whose  winter- records  show  a  mean  of  44.6°.  Monthly  means:  Sep- 
tember, 62.6°;  October,  55°;  November,  42°;  December,  35.4°; 
January,  32.6°;  February,  38.1°;  March,  46°;  April,  54.7°.  This 
cold  is  not,  however,  depressinj:  to  the  vitality  because  of  the  dry- 
ness of  the  atmosphere.  The  humidity-recards  are  as  follows  : 
January,  80  per  cent.;  April,  medium,  67  per  cent.;  minimum,  41 
per  cent.;  yearly  mean,  67  per  cent.;  rainfall  from  September  to 
December,  11.77  inches,  and  from  January  to  April,  4.33  inches. 

Every  attention  is  given  to  making  Meran  as  attractive  as  pos- 
sible to  visitors.  There  is  a  fine  Kurhaus,  located  on  one  bank  of 
the  river  Passer,  and  containing  reading-  and  smoking-rooms,  re- 
ception- and  dining-rooms. 

Beside  the  grape-cure,  which  is  the  especial  feature  of  Meran, 
there  is  the  whey-cure,  administered  duriug  the  spring,  and  medi- 
cated baths  and  treatment  by  variations  of  barometric  pressure  in  a 
pneumatic  chamber  may  be  taken  at  all  seasons.  Speaking  of 
Meran  as  a  winter  health-resort.  Dr.  Yeo  says  :  "  The  class  of 
individuals  to  whom  the  climate  of  Meran  seems  best  suited  is  those 
suffering  from  pulmonary  disease,  who  find  by  experience  that 
a  dry  and  bracing  climate  suits  them  better  than  a  warm,  moist 
one,  and  who  can  bear  a  certain  amount  of  cold  in  winter  without 
being  made  uncomfortable  by  it." 

Dr.  St.  Clair  Thompson,  who  was  at  Meran  in  the  year  1885, 
observes  :  "For  a  short  stay  it  is  of  use  to  patients  to  break  their 
journey  in  travelling  either  north  or  south,  to  avoid  too  sudden 
transitions  of  climate.  To  the  large  number  of  invalids  with  whom 
its  climate  agrees  it  offers  the  advantage  of  allowing  a  more  pro- 
longed stay  than  most  health-resorts — a  boon  to  many  to  whom 
trav^elling  is  unpleasant  or  impossible.  With  a  summer  visit  to  the 
neighboring  mountain-villages,  many  spend  the  whole  or  greater 
part  of  the  year  here." 

Hungary. 

The  resorts  in  Hungary  are  comparatively  little  known,  and  it 
is  always  hard  to  get  statistical  information  from  such  a  distance; 

1  See  Yeo's  Climate  and  Health-resorts. 


408  MEDICAL  CLIMATOLOGY. 

but  amouo-  the  places  which  have  come  under  the  notice  of  medical 
men  of  this  and  other  countries  may  be  mentioned  the  following  : 

Bartfeld,  in  the  northern  part  of  the  Theissan  district,  near  the 
Galician  border,  has  a  good  establishment  for  the  application  of  the 
waters  of  the  alkaline  chalybeate  springs  found  there. 

Szobrancz,  also  in  the  Theissau  district,  but  lying  to  the  south- 
west of  Bartfeld,  is  surrounded  by  beautiful  and  picturesque  scenery, 
and  possesses  saline  sulphurous  waters.     This  spa  is  very  popular. 

Herculesbad,  called  also  Mehadia,  lies  in  the  extreme  south- 
eastern part  of  Hungary,  in  a  wild  and  mountainous  region.  Here 
are  found  alkali-saline  sulphurous  waters,  having  a  temperature  of 
from  80°  to  130°  F.,  and  a  large  bathing-establishment. 

Baassen  possesses  saliue-bromo-ioduretted  waters,  with  a  tem- 
perature of  50°  F.  They  are  said  to  be  good  in  cases  of  chronic 
uterine  enlargement  and  in  secondary  syphilis. 

Harkanyi  is  picturesquely  situated,  and  has  alkaline  sulphurous 
springs  whose  waters  have  a  temperature  of  130°  F. 

Russia. 

The  resorts  of  this  extensive  portion  of  Europe  are  few  in  number 
and  are  rarely  used  by  foreigners. 

The  greater  part  of  the  country  is  flat.  It  is  very  cold  in  winter 
and  hot  in  summer.  There  is  no  district  of  Russia  where  the  sum- 
mer heat  is  not  comparatively  great,  the  thermometer  rising  to  86°  F. 
or  thereabout  and  descending  in  winter  as  low  as  13°  and  even  22° 
below  zero.  These  temperatures  have  been  noted  both  at  Astrakhan, 
in  the  far  south,  and  at  Archangel,  in  the  extreme  north.  The  range 
for  the  country  generally  averages  140°,  but  on  the  shores  of  the 
Black  Sea  it  is  reduced  to  108°.  The  summer  climate  of  the  Crimea 
is  reported  as  pleasant  and  healthy,  and  there  are  said  to  be  fairly 
cool  summer-resorts  on  the  coast  of  the  Black  Sea.  The  rainfall 
throughout  the  country  is  small,  from  16  to  23  inches  for  the  year, 
and  by  far  the  greater  precipitation  is  during  summer.  The  spring 
is  warmer  than  the  fall.  The  effect  of  the  Atlantic  winds  is,  how- 
ever, sufficiently  felt  to  qualify  the  Continental  character  of  the 
Russian  climate.  These  winds  lessen  the  cold  of  the  unusually  long 
winters  and  add  to  the  dampness  in  summer,  at  which  season  they 
also  sometimes  bring  thunderstorms. 

The  steppes  of  Tartary,  at  least  the  barren  portions  of  them,  are 
characterized  by  a  fine,   dry,  desert-air,   and   have  an   established 


EUROPE.  409 

reputation  for  the  relief  of  cousumption — the  vahie  of  the  climate 
being  increased  by  the  fact  that  these  districts  in  many  parts  have 
considerable  and  varying  elevation,  from  the  sinks  around  the  Cas- 
pian Sea  to  the  higher  benches  approaching  the  mountain-ranges. 
The  benefit  derived  from  residence  on  these  portions  of  the  steppes 
is  doubtless  enhanced  by  the  open  tent-life  and  the  drinking  of  kou- 
miss, a  fermented  preparation  of  mare's  milk  made  and  used  by  the 
Tartars. 

Germany. 

Pyrmont,  in  the  northern  part  of  Germany,  near  Hanover,  is 
delightfully  situated  in  the  Emmer  valley,  and  has  claims  to  con- 
siderable importance  as  a  spa.  It  has  two  salt  springs,  the  weaker 
one  of  which  contains  a  good  deal  of  carbonic  acid.  There  is  also 
an  iron  spring  of  some  strength,  more  than  is  possessed  by  those  at 
Schwalbach  and  St.  Moritz;  but  it  is  by  no  means  so  agreeable  to 
the  taste,  owing  to  the  presence  of  a  small  amount  of  sulphate  of 
magnesia.  Pyrmont  has  a  mild,  healthy  climate,  and  is  resorted  to 
by  those  who  have  chlorosis  or  anaemia  or  suffer  from  obesity  or 
atonic  dyspepsia. 

Analysis  of  Steel-spring  at  Pyrmont.' 


Bicarbonate  of  protoxide  of  iron 

.      0.57 

Bicarbonate  of  lime 

.     10.47 

Sulphate  of  magnesia         .... 

.       3.88 

Sulphate  of  lime 

.       9.05 

Free  carbonic  acid 

.     29  cub.  in 

Temperature 

.     55.8°  F. 

Aachen  or  Aix-la-Chapelle  lies  one  hour's  journey  from  Cologne. 
It  has  a  rather  damp  climate.  Here  are  found  hot  sulphur  springs, 
the  principal  one  being  the  Kaiserquelle,  and  the  waters  are  thought 
to  be  specially  good  in  cases  of  syphilis  and  useful  in  a  less  degree 
for  gout  and  rheumatism.  In  sixteen  ounces  of  the  water  from  the 
Kaiserquelle  were  found  31.9  grains  of  solid  and  26 J  cubic  inches 
of  gaseous  constituents. 

Xear  Aachen  is  Burtscheid,  where  are  warm  sulphur  springs, 
which  are  used  both  for  drinking  and  bathing.  The  Miihlenbad 
Quelle,  the  waters  of  which  are  the  hottest  in  Germany,  has  a  tem- 
perature of  171.5°  F. 

1  Braun's  Curative  Eflfects  of  Baths  and  Waters. 


410  MEDICAL  CLIMATOLOGY. 

Johannisberg,  lying  on  the  river  Rhine,  is  one  of  the  places 
known  as  a  station  for  the  grape-cure.  It  has  a  hydropathic 
establishment,  of  which  one  of  the  features  is  a  system  of  electro- 
therapeutics.    The  accommodations  are  good. 

Neuenahr,  in  the  valley  of  the  Ahr,  a  small  tributary  of  the 
Rhine,  lies  between  the  cities  of  Bonn  and  Coblenz.  Between 
Remagen  and  Neuenahr  is  one  hill,  900  feet  in  height,  called  the 
Laudskron,  and  near  this  is  located  the  Apollinaris  Brunnen,  the 
source  from  which  comes  that  mineral  table-water  now  so  famous 
all  the  world  over.  The  Landskron  is,  however,  the  one  notable 
point  in  the  scenery  thus  far,  the  surroundings  being  otherwise 
rather  uninteresting.  Above  Neuenahr  we  come  to  the  ancient  and 
interesting  town  of  Ahrweiler  and  the  village  of  Altenahr,  and 
through  this  district  the  views  are  most  picturesque.  The  banks 
of  the  river  are  covered  with  terraced  vineyards,  the  grapes  from 
which  are  made  into  a  red  wine  which  is  highly  esteemed.  Neuenahr 
has  some  not  very  powerful  alkaline  springs,  charged  to  saturation 
with  carbonic-acid  gas.  The  waters  have  a  temperature  ranging 
from  72p  to  104°  F.  There  is  a  creditable  Kurhaus  pleasantly 
situated,  the  mode  of  life  is  simple  and  wholesome,  and  the  food  is 
good.  It  is  stated  that  the  climate  is  dry,  healthy,  and  equable, 
but  that  heavy  mists  are  not  infrequent  in  the  morning.  The  town 
is  somewhat  warm,  although  there  is  usually  a  breeze  through  the 
valley. 

Grorbersdorf,  in  Silesia,  situated  at  a  height  of  1700  feet  above  the 
sea,  is  well  known  as  a  resort  for  phthisical  invalids  and  as  the  seat 
of  Dr.  Brehmer's  sanitarium.  This  fine  building  is  located  near 
a  hill  covered  with  pine-woods,  and  has  covered  walks  and  a  winter 
garden  which  is  adequately  heated.  The  grounds  are  peculiarly 
attractive.  There  is  nothing  especially  beneficial  in  the  climate  for 
consumptives  except  its  purity  and  the  opportunities  afforded  for 
living  out  of  doors. 

Laubbach,  not  far  from  Coblenz,  is  a  summer-  and  autumn-resort 
lying  amidst  beautiful  scenery  and  said  to  be  especially  healthful 
for  those  who  suffer  from  kidney-troubles.  There  is  treatment  by 
inhalations,  and  the  milk-  and  grape-cures  are  also  administered 
here.  The  climate  is  invigorating,  the  place  amusing,  and  the 
charges  moderate. 

Palkenstein,  another  Rhenish  health-resort,  is  important  chiefly 
because  of  the  establishment  there  by  Dr.  Dettweiler  of  a  sanitarium 


EUROPE.  411 

for  the  treatment  of  consumptives,  ausemie  patients,  and  conva- 
lescents. The  building,  standing  at  an  altitude  of  1700  feet,  is  in 
a  protected  situation,  being  sheltered  to  the  north  by  the  Tauuus 
Mountains  and  to  the  eastward  and  westward  by  lesser  elevations. 
The  most  careful  and  firm  supervision  is  maintained  over  every 
detail  of  an  invalid's  daily  life,  and  the  arrangements  of  the  sani- 
tariura  are  very  complete.  It  is  chiefly  to  these  facts  that  Dr.  Dett- 
weiler  attributes  the  undoubted  excellence  of  his  results.  Hydro- 
therapy and  the  application  of  electricity  are  included  in  his  treat- 
ment. 

WieBbaden,  not  far  from  Schwalbach,  is  one  of  the  oldest  water- 
ing-places in  Germany,  and  is  a  town  of  considerable  size,  having 
over  50,000  inhabitants.  The  waters  here  have  for  their  main 
solid  ingredient  common  salt,  and  the  temperature  of  the  chief 
spring,  the  Koch  Brunnen  or  boiling  well,  is  153°  F.  There  are 
very  good  bathing-arrangements  at  Wiesbaden,  and  the  milk-  and 
whey-cures,  and,  in  the  autumn,  the  grape-cure,  are  also  admin- 
istered. The  waters  are  particularly  good  for  chronic  rheumatism. 
Wiesbaden  has  first-rate  hotels  and  numerous  and  good  lodging- 
houses,  and  the  rates  of  living  are  moderate.  The  magnificent  Kur- 
saal  contains  library  and  reading-rooms  and  restaurant,  and  here  are 
given  concerts,  weekly  balls,  etc.,  and  beautiful  walks  and  drives 
may  be  taken  through  the  surrounding  country.  Wiesbaden  is  used 
as  a  resort  both  in  winter  and  summer,  and  its  winter  climate, 
although  cold,  is  dry  and  sunny. 

Schwalbach,  situated  at  an  elevation  of  almost  1000  feet,  amidst 
a  picturesque  district  in  Nassau,  is  a  small  village  lying  at  a  dis- 
tance of  nine  miles  from  Eltville,  a  Rhine  station.  The  new  part, 
where  are  the  visitors'  quarters,  is  built  upon  the  sides  of  two  val- 
leys, which  meet  just  where  the  new  Kursaal  is  built.  This  is  the 
iron-cure  of  Germany,  and  is  especially  prescribed  in  cases  of  anaemia 
and  bloodlessness  resulting  from  hemorrhage.  The  waters  are  used 
for  both  drinking  and  bathing,  and  contain,  beside  iron,  some  car- 
bonic acid  gas.  The  climate  is  stimulating.  Many  amusements 
are  provided  at  Schwalbach  for  the  diversion  of  visitors,  and  enjoy- 
able excursions  may  be  taken  through  the  surrounding  country. 

Nauheim,  lying  at  the  foot  of  the  Johannisberg  Mountain,  about 
twenty  miles  from  Frankfurt  and  twelve  from  Homburg,  has  many 
claims  to  popularity.  The  springs  give  forth  muriated  saline  waters 
of  some  strength,  which  are  charged  with  carbonic  acid  gas.     The 


412 


MEDICAL  CLIMATOLOGY. 


Stahlbrunn. 

Weinbr. 

Pauline  nbr. 

0.64  gr. 

0.44  gr. 

0.51  gr. 

0.14 

0.07 

0.09 

1.63 

4.46 

1.23 

1.67 

439 

1.65 

0.15 

1.88 

0.13 

50  cub.  in. 

45  cub.  in. 

40  cub.  in 

waters,  which  have  a  temperature  of  96.4°  F.,  are  useful  iu  cases  of 
enlargement  of  the  liver  and  spleen  and  in  scrofula.  There  are 
good  bathing  appliances  and  a  salle  d'inhalation. 

Analysis  op  Schwalbach  Waters.' 

Bicarbonate  of  protoxide  of  iron 
Bicarbonate  of  magnesium   . 
Bicarbonate  of  magnesia 
Bicarbonate  of  lime 
Bicarbonate  of  soda 
Carbonic  acid 
Temperature,      47.8°  to  50°, 

Kreuznach  is  located  on  the  river  Rhine,  not  far  from  Bingen, 
at  an  elevation  of  280  feet.  Xeither  the  town  itself  nor  its  situation 
is  so  interesting  as  many  of  the  Rhenish  resorts.  The  springs  which 
are  used  for  bathing  are  at  some  distance  from  Kreuznach,  but  the 
one  spring  which  is  used  for  drinking — the  Elizabeth — rises  very 
near  the  Kursaal.  Althouarh  the  waters  contain  a  verv  little  of 
certain  compounds  of  bromine  and  iodine,  they  must  be  regarded 
practically  as  strong  salt  springs.  The  Elizabeth  spring  contains 
in  one  pint  of  water  94  grains  of  solid  ingredients,  and  of  these  73 
grains  are  of  chloride  of  sodium,  about  \  of  a  grain  of  bromide  of 
magnesium,  0.03  of  a  grain  of  iodide  of  magnesium,  and  13  grains 
of  chloride  of  calcium.  The  dose  is  at  first  small  and  is  gradually 
raised  to  about  a  pint  a  day.  The  bath  is,  however,  the  most  im- 
portant method  of  application. 

Baden-Baden  lies  at  the  head  of  the  Black  Forest,  in  the  midst 
of  the  most  beautiful  scenery.  The  season  here  is  from  May  to 
October,  during  which  time  people  come  to  take  the  waters,  which 
are  of  the  simple  saline  variety  and  have  a  temperature  ranging  from 
110°  to  150°  F.     Baths  are  given  for  paralysis  and  rheumatism. 

At  Reiboldsgrun,  in  Silesia,  which  has  an  elevation  of  2200  feet, 
is  a  sanitarium  in  charge  of  Drs.  Koeppe  and  Wolf,  physicians  well 
known  through  their  experiments  as  to  the  influence  of  altitude  on 
blood-chauo;es. 

Rippoldsau,  situated  below  the  Kniebis,  the  highest  peak  in  the 
Black  Forest,  and  surrounded  by  pine-woods,  is  a  village  with  a 
population  of  800,  lying  amidst  romantic  and  beautiful  scenery  and 


1  Braun's  Curative  Effects  of  Batlis  and  Waters. 


EUROPE.  413 

resorted  to  both  for  its  climate  and  its  mineral  waters.  The  waters 
may  be  classed  as  saline  chalybeate.  The  whey-  and  milk-cures 
are  also  features  of  this  resort,  which  is  much  frequented  by  phthisi- 
cal invalids  during  the  summer.  The  beautiful  surroundings  have 
been  rendered  still  more  attractive  by  every  resource  which  art  can 
bring  to  the  aid  of  nature. 

Kissingen,  in  Bavaria,  has  an  elevation  of  over  600  feet,  and 
though  not  so  gay  as  Homburg,  it  is  celebrated  for  its  waters,  which 
are  efficacious  in  cases  of  dyspepsia,  abdominal  plethora,  and  disor- 
ders of  the  liver.  There  are  three  springs — the  Rakoczy,  tiie  Pan- 
dur,  and  the  Maxbrunnen — the  latter  being  weaker  than  the  others  ; 
these  have  muriated  saline  waters.  Two  springs  are  used  for  bath- 
ing— the  Sool-sprudel  and  the  Schon-sprudel.  Prince  Bismarck 
lives  at  Kissingen  for  two  months  out  of  every  year.  It  is  a  place 
of  10,000  inhabitants,  and  everything  is  done  to  make  the  town 
charming  for  visitors.  Between  the  Kurhaus  and  the  Kur-saal  is  a 
fine  promenade  or  Kurgarten,  and  Kissingen  has  also  a  small  theatre. 
There  are  two  smaller  spas  near  by,  Brooklet  and  Briickenau. 

Analyses  of  Rakoczy  and  Maxbrunnen  at  Kissingen.' 


Rakoczy. 

Maxbrunnen 

la  16  oz. 

In  16  oz. 

Chloride  of  sodium 

44.71  gr. 

17.520  gr. 

Chloride  of  potassium    . 

2.20 

1.140 

Chloride  of  lithium 

0.15 

0.004 

Chloride  of  magnesium 

2.33 

0.510 

Sulphate  of  magnesium 

4.50 

1.820 

Sulphate  of  lime    .... 

2.99 

1.060 

Carbonate  of  lime. 

8.14 

4.620 

Carbonate  of  protoxide  of  iron 

0.24 

Free  carbonic  acid,  41  cubic  inches. 

Switzerland. 

Seelisberg,  in  the  Canton  of  Uri,  is  a  summer  health-resort 
possessing  a  mild  climate,  a  humid  air,  and  attractive  surroundings. 
The  scenery  is  fine  and  the  district  is  also  hi.storically  interesting. 
The  situation  is  sheltered.  There  are  good  baths,  and  the  resort  is 
much  patronized.  No  account  of  Seelisberg  would  be  complete 
without  mention  of  the  really  splendid  Hotel  Sonnenberg,  with  its 
luxurious  arrangements  for  visitors. 

1  Yeo's  Climate  and  Health-resorts. 


414  MEDICAL  CLIMATOLOGY. 

Montreux  is  situated  upon  the  uortheastern  shore  of  Lake  Geneva, 
on  a  small  indentatioo  known  as  the  Bay  of  Montreux.  Its  situa- 
tion is  more  sheltered  than  that  of  other  villages  in  the  district. 

The  climate  is  fairly  open,  dry,  and  sunny,  there  being  about 
60  rainy  days  during  the  year;  the  rainfall  is,  however,  large. 
The  mean  yearly  rainfall,  as  shown  by  the  records  for  seven  years, 
was  50  inches,  while  that  of  Geneva  was  only  32  inches.  Winds 
are  rare. 

There  are  numerous  good  hotels  and  pensions. 

The  grape-cure,  given,  among  other  stations,  at  Meran  and  in 
Montreux  and  its  vicinity,  and  said  to  be  efficacious  for  various 
disorders,  but  especially  in  phthisis  and  general  debility,  claims, 
as  chief  among  its  advantages,  the  prevention  of  waste  of  the  system 
and  the  properties  of  a  safe  and  mild  aperient.  It  is  given  in  the 
autumn,  during  the  months  of  September  and  October.  Patients 
take  the  grapes  before  a  light  breakfast,  going  out  to  purchase 
them,  and  eating  them  while  they  wander  about.  The  ordinary 
dose  is, from  two  to  four  pounds  daily,  but  it  may,  in  exceptional 
cases,  rise  as  high  as  six  pounds. 

Arosa  is  situated  in  a  narrow  valley  Avhich  joins  with  the  Schon- 
figg  valley  at  Langwies.  It  lies  at  au  elevation  of  more  than  6000 
feet.  The  climatic  characteristics  are  said  to  be  similar  to  those  of 
Davos,  but  Arosa  has  from  half  an  hour  to  an  hour  more  sunshine, 
even  in  the  midst  of  wiuter,  than  Davos.  There  are  three  hotels 
beside  the  Pension  Brunakl,  which  is  the  only  one  open  for  the 
reception  of  visitors  during  the  winter.  The  village  is  picturesque, 
but  it  is,  or  was  as  late  as  1800,  reached  only  by  a  bridle-path, 
which,  of  course,  would  render  it  difficult  of  access  for  many  in- 
valids. At  Arosa  were  conducted  the  elaborate,  exact,  aud  success- 
ful experiments  of  Dr.  Egger  to  investigate  the  changes  in  blood 
caused  by  altitude.  The  place  is  resorted  to  in  winter  by  phthisical 
invalids  whose  general  health  is  not  too  much  impaired,  and  in 
summer  by  patients  who  are  suffering  from  nervous  troubles. 

Davos.  The  district  of  Davos  (an  elevated  valley  of  the  Canton 
des  Grisons)  is  some  fourteen  miles  in  length.  The  portion  of  the 
valley  containing  the  well-known  health-resorts — Davos-Platz  and 
Davos-Dorfli — lies  at  an  altitude  of  about  5200  feet,  and  is  sur- 
rounded by  Alps  ranging  to  9000  and  10,000  feet  above  sea-level. 
It  is  sheltered  from  the  north  and  west  winds.  The  principal  vil- 
lage, Davos-Platz,  is  situated  on  the  northwestern  side  of  the  valley, 


EUROPE. 


415 


and  contains  nearly  all  the  hotels,  pensions,  and  shops.  Davos- 
Dorfli  in  winter  receives  the  snn's  rays  some  two  hours  earlier, 
although  it  loses  them  earlier  also. 

There  has  been  much  complaint  from  the  older  residents  of  the 
rapid  overcrowding  of  Davos  and  consequent  danger  of  poor  drain- 
age and  smoke-nuisance  ;  but  Dr.  C.  T.  Williams  stated  in  his  Lum- 
leian  Lectures  for  1893  that  there  were  no  grounds  for  this  feeling 
yet,  as  the  valley  is  wide  and  the  hotels  and  houses  scattered. 

The  climate  here  in  winter  is  very  cold,  with  a  few  hours  of  suffi- 
cient sunshine  to  allow  of  sitting  out  in  the  sun's  rays  ;  but  it  is  usu- 
ally freezing  in  the  shade,  and  at  night  the  mercury  falls  far  below 
the  freezing-point.  The  night-air,  while  cold,  is  dry,  and  invalids 
usually  sleep  with  their  windows  open. 

Table  III.— Davos-Platz.^ 


Monthly  mean. 


Winter  . 
Spring  . 
Summer 
Autumn 
Annual . 


Temper- 

Relative 

ature. 

humidity. 

Mean. 

Per  cent. 

23° 

82 

35 

74 

52 

74 

34 

79 

3S 

77 

Absolute 
humidity.  \ 
Grains  per  ' 
cubic  foot.  1 


Dew- 
point. 


1.21 
1.74 
3.29 
1.81 
2.03 


]8«= 

27 

44 

28 

31 


Clouding. 

Rainfall 

0  cloud- 

(total). 

less. 

Inches. 

10  sky- 

covered. 

6.1 

4.4        ' 

6.4 

5.2 

11.9 

5.1 

9.2 

4.9 

33.6 

4.9 

Wind. 

Miles  per 

hour. 


1.6 


3.4 
2.4 


Note. — Temperature,  humidity,  and  rain  and  snowfall  are  based  on  observations  for  tweuiy- 
one  years. 

Wind.  January,  February,  March,  April,  November,  and  December  from  records  for  four 
years  ;  August  from  records  of  two  years.  In  above  seasonal  report  for  the  wind-movement 
Winter  includes  December,  January,  and  February  ;  Spc/H.;/ includes  March  and  April ;  Hummer 
includes  August ;  Autumn  includes  September,  October,  and  November.  Other  months  are 
missing. 

The  mean  annual  temperature  in  Davos,  as  given  by  Mr.  Waters 
from  the  records  for  twenty-one  years,"  was  38°  F.  The  mean  tem- 
perature for  winter  was  23°,  for  spring  35°,  and  for  summer  52°. 
This  is  slightly  higher  for  the  winter-temperature  than  the  record 
of  the  meteorological  station  for  eight  years,  which  was  kindly  fur- 
nished by  Dr.  Carl  Ruedi.  That  was  20°  F.,  with  a  maximum  of 
42°  and  a  minimum  of  — 7.6°. 

There  is  freedom    from  wind  and    fog.       The    wind-record    in 


1  Some  Meteorological  Conditions  of  Davos.    Arthur  William  Waters,  Es<i.,  1890. 
-  Loc.  cit. 


416  MEDICAL  CLIMATOLOGY. 

Davos  during  the  winter,  taken  by  Mr.  Waters,  showed  from  9 
to  1  o'clock  a  movement  of  0.6  mile  per  hour,  and  from  1  to  3 
o'clock  a  movement  of  1.3  mile  per  hour.  The  mean  velocity  was 
for  winter  1.6  mile  and  for  spring  2.5  miles  per  hour. 

(For  comparison  with  Davos-Platz,  see  Denver,  Estes  Park, 
Colorado  Springs;  also  Table  II.  and  Tables  V.  to  XII.) 

The  relative  humidity  of  Davos  is  82  per  cent,  for  winter  and 
74  per  cent,  for  spring  and  summer;  but  the  absolute  humidity  is 
low  during  the  cold  months  on  account  of  the  extreme  low  tempera- 
ture. 

The  annual  rainfall  and  melted  snowfall  at  Davos  (from  the 
records  for  twenty-one  years)  are  33.6  inches,  of  which  the  seasonal 
fall  for  winter  is  6.1  inches;  for  spring,  6.4  inches;  for  summer, 
11.9  inches;  and  for  autumu,  9.2  inches. 

The  soil  of  the  valley  is  sandy  and  dry,  except  near  the  stream 
that  flows  down  the  centre.  During  the  winter  season,  however,  the 
ground  is  usually  covered  by  two  or  more  feet  of  snow. 

The  snow-melting  generally  begins  before  the  middle  of  March, 
and  the  usual  exodus  of  patients  takes  place  about  the  first  week  in 
April. 

Tarasp,  lying  in  the  district  known  as  the  Lower  Engadine,  at  an 
altitude  of  between  4000  and  5000  feet,  has  a  bracing  Alpine  climate, 
less  severe  than  that  of  resorts  in  the  Upper  Engadine  and  less  sub- 
ject to  sudden  changes  of  temperature.  The  air  also  is  neither  so 
dry  nor  so  rarefied,  and  is  free  from  dust.  The  ''season"  is  from 
June  until  the  end  of  August.  Tarasp  has  many  and  different 
mineral  springs,  some  being  saline-alkaline,  others  chalybeate,  and 
still  others  sulphurous  ;  the  waters  also  contain  Glauber's  salt. 
The  saline-alkaline  springs  are  the  most  important,  and  are  used  for 
both  drinking  and  bathing.  The  Tarasp  water  is  very  rich  in  free 
and  half-free  carbonic  acid,  and  Dr.  Yeo  says  ''  that  there  is  scarcely 
a  spring  in  Europe  that  is  known  to  possess  so  many  important 
qualities." 

Wiesen  (elevation,  4770  feet)  is  well  situated  on  sloping  ground, 
and  has  a  dry  surface.  The  scenic  surroundings  are  picturesque 
and  pretty,  and  the  place  is  rather  more  sheltered  from  cold  winds 
than  Davos,  near  which  it  lies.  The  hours  of  sunshine  on  the 
shortest  winter-days  are  from  10  o'clock  in  the  morning  until  3  in 
the  afternoon.  The  place  is  quieter  than  Davos  or  St.  Moritz,  and 
the  accommodations  are  spoken  of  as  excellent. 


EUROPE.  417 

Andermatt,  reached  by  the  Gotthard  Railroad,  and  therefore 
easily  accessible  to  invalids  who  would  otherwise  be  debarred  from 
its  advantages,  is  used  as  a  health-resort  both  in  winter  and  summer. 

In  this  district  the  snow  lies  from  about  the  middle  of  October 
until  the  latter  part  of  April,  and  the  number  of  snowy  days  from 
October  to  March  is,  as  stated  by  Dr.  Loetscher,  52.  Of  dull  and 
cloudy  days  he  gives  67,  and  says  that  there  are  more  misty  days 
during  the  winter  than  at  Davos. 

In  the  Ober-Alp  Lake  there  is  fishing,  and  many  beautiful  excur- 
sions may  be  taken  from  Andermatt.  The  accommodations  are 
ample  and  good. 

Grindelwald,  situated  in  the  Bernese  Oberland  at  an  elevation 
of  3400  feet,  and  surrounded  by  the  finest  scenery,  is  a  climatic 
station.  The  narrow  valley  in  which  it  lies  runs  from  east  to  west, 
and  is  sheltered  from  north  winds  and  to  some  extent  from  east 
winds,  but  is  exposed  to  the  blasts  of  the  Fohn,  which  blows  from 
the  south  and  southwest. 

The  climate  is  bracing  and  the  winter-temperature  is  mild  and 
equable,  but  in  summer  it  varies  greatly. 

There  are  baths  for  the  benefit  of  patients,  and  excellent  ac- 
commodations, one  hotel,  the  Hotel  Zum  Schwarzen  Adler,  being 
especially  well  arranged. 

Leysin  is  situated  on  a  lofty  plateau  where  the  Ormont  valley 
joins  that  of  the  Rhone.  The  climate  is  rigorous  and  stimulating, 
and  is  recommended  by  Dr.  Bezeucent  for  scrofulous  and  spinal 
disorders  in  children, 

Miirren,  also  in  the  Oberland,  has  an  altitude  of  5000  feet,  and 
is  a  climatic  health-resort  possessing  the  grandest  scenic  surround- 
ings and  sheltered  from  the  north  and  northeast  winds.  Although 
the  climate  is  tonic,  the  air  is  milder  and  less  bracing  than  that  of 
the  Engadine  district.  Baths  and  the  whey-  and  milk-cures  are 
administered.      The  accommodations  are  good. 

Samaden,  5700  feet  above  sea-level,  is  a  small  town  lying  about 
three  miles  from  St.  Moritz,  and  has  a  less  interesting  situation  than 
many  of  the  Swiss  resorts.  It  is  somewhat  used  as  a  winter-resort, 
and  possesses  a  Kurhaus  for  the  housing  of  patients  during  that 
season.  This  establishment  is  Avell  heated  and  has  arrangements 
for  baths  and  douches.  One  of  the  hotels  has  also  been  kept  open 
during  the  winter  for  some  time  past.  The  view  of  the  Berniua 
range  from  Samaden  is  very  fine. 

27 


418  MEDICAL  CLIMATOLOGY. 

St.  Moritz  lies  in  tiie  Upper  Engadine,  at  an  elevation  of  6080 
feet,  surrounded  by  lofty  mountains  and  fairly  well  sheltered  from 
the  wind.  The  winter  season  is  longer  than  at  Davos,  and  a  greater 
amount  of  snow  falls.  From  some  observations  made  by  Mr. 
Waters  in  St.  Moritz^  in  1882-'83  the  temperature  during  the  day 
was  found  to  be  in  January,  taken  at  9,  1,  and  3  o'clock,  18°, 
27°,  and  27°  F.,  respectively,  and  in  March,  at  the  same  hours, 
20°,  26°,  and  25°.  The  highest  wind-movement  was  between  1 
and  3  p.m.,  and  recorded  in  January  3.3  miles  and  in  March  7.7 
miles  per  hour  during  those  hours. 

The  baths  of  St.  Moritz  lie  in  the  plain,  300  feet  below  the  upper 
village.  St.  Moritz  has  a  summer  season  from  June  15th  to  Sep- 
tember 1st.  Rain  may  be  expected  in  summer  one  day  out  of  three.^ 
The  mean  temperature  for  the  four  months  June  to  September,  for 
eight  years,  based  upon  three  daily  observations,  was  51°  F.  Maxi- 
mum, 78° ;  minimum,  32°.  In  October  the  weather  begins  to  be  quite 
cold.  Heavy  snows  begin  in  November.  The  hotels  at  St.  Moritz 
are  excellent. 

Pontresina,  situated  in  the  Upper  Engadine,  at  an  elevation  of 
nearly  6000  feet,  is  a  small,  but  much-visited  hamlet,  having  a 
population  of  400  and  containing  good  hotels.  There  is  a  mag- 
nificent view  to  eastward  and  southward. 

From  the  peculiarity  of  its  situation,  at  the  open  meeting-point 
of  two  valleys,  Pontresina  has  a  great  many  hours  of  sunshine  ;  but 
the  same  peculiarity  makes  it  subject  to  cold  winds  and  mists.  Its 
climate  is  very  bracing,  and  is  rendered  more  so  by  the  proximity 
of  glaciers. 

It  is  a  fashionable  summer-resort  from  which  consumptives  are, 
as  far  as  possible,  excluded,  and  it  is  much  used  as  a  starting-point 
for  climbing  the  adjacent  mountains  and  glaciers. 

Maloja  (6000  feet)  is  a  plateau  situated  at  the  higher  or  south- 
west end  of  the  Upper  Engadine,  where  the  Fohu  or  warm  southern 
wind  is  seldom  felt.  Dr.  Tucker  Wise  took  meteorological  obser- 
vations at  Maloja  for  several  winters.  The  mean  day-temperature 
of  1883-'84  was  25°  F.  for  November,  December,  January,  and 
February.  The  maximum  temperature  during  these  four  months 
was  45°  (December  26th)  and  the  minimum  — 7°  (February  19th). 
The  maximum  solar  radiation  was  143°  (on  February  13th).     The 

1  Observations  made  in  St.  Moritz,  in  the  winter  of  1882-'83.    Arthur  William  Waters,  Esq. 

2  The  Climate  of  St.  Moritz,  Upper  Engadine.    Walter  B.  Piatt,  M.D.,  Baltimore,  1887. 


EUROPE.  419 

mean  day-temperature  of  1884-85  (November  to  March)  was  26°, 
and  of  the  winter  of  1885-86  (November  to  March)  23°.  The 
average  relative  humidity  for  the  last-named  period  was  76  per  cent. 
Dr.  Wise  says  the  temperature  is  more  equable  than  at  Davos,  but 
there  is  more  valley-wind.  The  winter  season  at  Maloja  lasts  a 
little  longer.  There  is  a  fine  hotel  at  Maloja,  open  throughout  the 
winter. 


CHAPTER    XVIII. 

:  AFRICA— ASIA— AUSTEALASIA. 

Bg-ypt. 

This  country  has  long  been  used  as  a  winter  sanitarium.  It  has 
the  advantages  of  the  desert  in  its  dry  air  and  the  absence  of  rain. 

Cairo  (latitude,  30°  3'  north  ;  population,  400,000)  has  an  annual 
mean  temperature  of  72°  F. ,  with  extremes  during  the  year  from 
35°  to  111°.  The  mean  temperature  for  winter  is  58°.  There  is  a 
great  difference  between  the  day-  and  night-temperatures,  due  to 
radiation,  which  in  winter  amounts  to  23°  or  even  38°.  Freezing- 
point  is  not  reached  in  Cairo,  but  absolute  minima  of  35°  and  36° 
have  been  recorded. 

From  Egypt  as  a  Winter-resort,  by  Dr.  F.  M.  Sandwith,  of  Cairo, 
the  following  temperature-records  have  been  taken : 

Mean  temperature. 


Max. 

Min. 

Monthly. 

October 

.     84° 

65° 

74° 

November     . 

.     74 

56 

64 

December 

.     68 

50 

58 

January 

.     61 

47 

54 

February 

.     65 

49 

57 

March  . 

.     73 

53 

63 

April     . 

.     81 

60 

70 

The  annual  rainfall  is  1^-  inches,  with  from  12  to  15  rainy  days. 
The  annual  mean  relative  humidity  is  56  per  cent.;  for  the  winter 
it  is  66  per  cent.  The  difference  between  the  dry  and  wet  bulbs 
sometimes  amounts  to  24°  F. 

The  air  of  the  desert  is  exceedingly  pure.  The  climate  suffers 
from  hot  southeast  winds,  which  are  veiy  distressing.  A  visitor* 
speaks  of  the  weather  from  November  to  March  as  for  the  most 
part  bright  and  sunny,  and  not  too  warm.  There  are  occasionally 
cloudy  and  comparatively  cold  days,  with  rain,  between  the  middle 
of  December  and  the  middle  of  February. 

1  Winters  Abroad.    R.  H.  Otter,  M.A.,  Loudon,  1882. 


PLATE  X. 


.f"-:- 


RELIEF  MAP  OF  AFRICA. 


From  BUTLER'S  GEOGRAPHIES,  by  permission  ot  e.  h  butler  a  co.    Copyright.  1888. 


AFRICA— ASIA— AUSTRALASIA.  421 

Residence  in  Cairo  should  not  be  too  prolonged.  The  strongest 
objection  to  a  long  stay  on  the  part  of  an  invalid  lies  in  the  fact 
that  the  greater  part  of  the  European  quarter  of  the  city  is  built  on 
what  was  once  a  swamp  and  is  still  in  parts  very  swampy  ground. 
After  sunset  a  rising  fog  may  be  seen,  which  is  most  dangerous  to 
invalids.  Moreover,  the  country  around  Cairo  is  most  thoroughly 
irrigated,  and  where  the  rich  crops  of  grass  and  clover  are  culti- 
vated the  exhalations  from  the  moist  land  after  sunset  are  extra- 
ordinary. The  sand  and  dust  constantly  inhaled  during  the  day  are 
also  objectionable. 

Visitors  do  not  usually  go  to  Cairo  before  October,  and  leave 
before  the  end  of  April. 

The  sewers  of  Cairo  are  bad  and  the  death-rate  in  the  town 
population  is  surprisingly  large.^  Carefully  filtered  water  should 
always  be  used.  In  Lower  Egypt  and  near  the  Nile  dew  forms 
every  night.  At  Luxor  and  near  the  first  cataract  it  is  hardly 
noticeable. 

The  town  has  good  hotels,  but  the  means  for  heating  during  the 
rare  periods  of  cold  and  damp  weather  are  insufficient. 

Among  the  sources  of  discomfort  and  danger  to  delicate  invalids 
in  making  the  otherwise  delightful  voyage  up  the  Nile  in  a  daha- 
biyeh  are  the  fogs  on  the  river  for  one  hundred  miles  south  of  Cairo, 
the  cold  and  frosty  nights  in  the  desert,  and  the  strong  north  wind 
which  is  frequently  annoying  to  boats  coming  down  against  it.  But 
even  for  delicate  persons  the  Nile  voyage  is  a  pleasant  mode  of 
spending  a  portion  of  the  winter.  It  affords  plenty  of  air  without 
the  labor  of  exercise.  The  nights  are  cool  and  the  days  warm  and 
clear. 

Gizeh,  across  the  river,  seven  miles  from  Cairo,  with  one  good 
hotel,  and  Helouan,  fifteen  miles  from  Cairo,  where  there  are  two 
hotels,  and  villas  that  may  be  hired  for  the  season,  are  said  to  possess 
advantages  as  health-resort  stations. 

Luxor,  450  miles  south  of  Cairo,  has  a  still  drier  air.  The  popu- 
lation of  Luxor  is  4000,  and  there  are  two  hotels.  It  seldom  rains 
here  and  the  wind-movement  is  very  small.  The  only  objectionable 
wind  is  the  "  khamsin,"  from  the  south  or  southwest,  which  usually 
blows  for  three  days  at  a  time.  It  is  seldom  troublesome  during 
the  winter  months,  but  is  more  prevalent  in  the  spring. 

1  Wintering  in  Egypt.    Frederick  Peterson,  M.D.,  In  New  York  Medical  Record,  August,  1892. 


422  MEDICAL  CLIMATOLOGY. 

Algeria. 

This  French  province  on  the  north  coast  of  Africa  has  been  greatly 
used  as  a  winter-resort,  although  it  has  not  won  unreserved  praise  as 
a  suitable  climate  for  sufferers  from  pulmonary  disease. 

The  Atlas  Mountains  traverse  Algiers  in  three  chains,  running 
east  and  west,  and  rising  in  places  to  a  height  of  7000  feet.  South  of 
the  last  chain  stretches  the  Great  Sahara  Desert,  which,  according  to 
Dr.  Bennet,  is  the  key  to  the  Algerian  climate  and  converts  what 
would  otherwise  be  a  dry  climate  into  a  moist  one.  This  is  explained 
by  the  fact  that  the  atmosphere  overlying  this  rainless  tract  of  desert, 
becoming  heated  both  winter  and  summer,  rises  into  the  higher 
strata,  and  thus  a  vacuum  is  formed,  which  the  cooler  air  from  the 
Mediterranean  basin  rushes  in  to  fill,  being  sucked  in  over  the  sum- 
mits of  the  Atlas  ranges.  Consequently  the  regular  winds  are  and 
nmst  be  northeast  and  northwest,  and  south  winds  only  blow  excep- 
tionally, though  the  sirocco,  when  it  blows,  is  a  terrible  blast  from 
the  desert.  These  northerly  winds  coming  from  the  Mediterranean 
or  the  Atlantic  are  laden  with  moisture,  and  striking  the  Atlas 
ranges  are  at  once  cooled  and  condensed  and  deposit  their  moisture 
in  the  form  of  frequent  and  abundant  rain  over  the  entire  Algerian 
region,  reaching  into  the  desert  two  hundred  and  fifty  miles  from  the 
sea.  The  rainfall  is  consequently  heavy,  the  annual  average  for 
Algiers  being  40  inches,  distributed  over  about  87  days,  principally 
in  winter ;  the  greatest  number  of  rainy  days  usually  occurs  during 
I^ovember,  December,  and  January,  which  is  a  decided  drawback  for 
visitors.  The  rainfall  increases  to  the  eastward,  the  westerly  province 
of  Oran,  where  there  are  few  or  no  forests,  having  the  least  rain. 

Algiers  (latitude,  36°  47'  north),  a  town  with  a  population  of 
75,000,  has  a  mean  annual  temperature  of  64°  F. ;  the  mean  for 
winter  being  55°  and  for  spring  'dQ°.  The  annual  mean  of  relative 
humidity  is  73  per  cent.,  which  varies  but  little  during  the  year. 
The  dews  of  summer-nights  are  very  heavy.  Williams  considers 
the  climate  as  milder  and  moister  than  that  of  the  Riviera  and 
occupying  an  intermediate  place  between  it  and  that  of  Tangier 
(Morocco),  where  the  equalizing  influence  of  the  A.tlantic  is  more 
felt  in  moderating  the  extremes.  Bennet  is  authority  for  the  state- 
ment that  ''the  monthly  temperature  is  one-third  higher  than  the 
Riviera,  on  account  of  the  warmer  nights. "  Except  for  a  month 
or  thereabout  during  each  year  the  wind  is  from  the  north.    Algiers 


AFBICA— ASIA— AUSTRALASIA.  423 

has  a  choice  of  suburbs  and  hill  stations,  the  principal  suburb  being 
Mustapha  Saperieur,  where  furnished  villas  may  be  hired.  The 
drawbacks  of  residence  in  Algiers,  aside  from  the  dirt,  odors,  and 
bad  drainage,  are  the  amount  and  season  of  the  rainfall  aud  the 
periods  of  dust  and  extreme  heat,  although  the  winters  differ 
greatly  in  these  respects. 

Oran  (latitude,  35°  44'  north  ;  population,  70,000).  This  por- 
tion of  Algiers  is  reported  to  have  a  good  winter  climate,  with  less 
rainfall  than  Algiers.  Oran  is  an  old  town,  lying  at  the  head  of  a 
bay.  There  are  several  beautiful  promenades.  The  water-supply 
is  said  to  be  good.  Regular  steamers  go  to  Marseilles,  Barcelona, 
Valencia,  Maloja,  and  Gibraltar.     It  is  261  miles  by  rail  to  Algiers. 

Biskra  or  Biskara  (latitude,  35°  27'  north  ;  populatiou,  7200). 
An  important  French  military  post,  reached  by  rail  from  Algiers 
or  Phillippeville  via  Constantine.  Biskra  is  situated  ou  an  elevated 
tableland  on  the  south  side  of  the  Aures  Mountains,  an  extension 
of  the  Atlas  range.  From  this  oasis  on  the  northern  edge  of  the 
Sahara  caravans  start  for  their  journeys  across  the  great  desert. 
The  streets  of  the  town  are  broad,  with  one-story  houses,  built 
largely  of  brick.  The  accommodations  have  been  well  spoken  of. 
The  winter  season  is  prolonged  well  into  spring.  The  summers 
are  unbearably  hot. 

Tangier  (Morocco)  (latitude,  35°  47'  north  ;  population,  15,000). 
This  Arab  town,  which  contains  usually  but  300  or  400  resident 
Europeans,  is  finely  situated  on  a  bay  on  the  Strait  of  Gibraltar, 
fourteen  miles  east  of  Cape  Spartal.  The  distance  across  to  the 
town  of  Gibraltar  is  thirty-eight  miles  northeast. 

Tangier  is  a  wretchedly  built  place,  with  few  comfortable  houses. 
The  streets  are  narrow,  crooked,  and  very  dirty.  The  whole  appear- 
ance is  that  of  an  old,  decaying  town.  The  water-supply  is  poor 
and  particularly  bad  in  summer.  As  the  streets  are  poorly  paved 
and  there  are  no  wheeled  vehicles,  visitors  find  it  necessary  to  go 
about  on  horseback. 

There  is  a  modern  hotel  offering  good  accommodations. 

Dr.  Williams  says:  ''Tangier  has  long  been  noted  for  its  remark- 
able climate,  which  apparently  combines  the  warmth  of  the  Mediter- 
ranean with  the  equability  of  the  Atlantic,  aud,  being  separated  by 
a  series  of  mountain-ranges  from  the  Sahara  Desert,  does  not  share 
all  the  features  of  the  Algerian  climate,  though  its  rainfall  is  large — 
30  inches — occurring  chiefly  in  October  and  November.     The  mean 


424  MEDICAL  CLIMATOLOGY. 

winter-temperature  is  about  60^  F.  and  the  diurnal  variations  are 
slight.  The  climate  is  miid,  with  a  bracing  element,  owing  to  At- 
lantic winds." 

South  Africa. 

The  South  African  Highlands  have  a  number  of  stations  which 
have  been  used  by  English  invalids,  situated  in  Cape  Colony,  the 
Orange  Free  State,  and  the  Transvaal  or  South  African  Kepublic. 

There  are  two  lines  of  mail  steamers  plying  between  Loudon  and 
the  Cape  of  Good  Hope,  touching  at  Madeira  and  sometimes  at 
Ascension  and  St.  Helena.  The  voyage  on  the  larger  ships  has 
been  reduced  to  about  seventeen  days. 

Since  the  importance  of  the  diamond  and  gold  mines  has  been 
realized  railway  communication  throughout  South  Africa  has  been 
greatly  extended,  and  nearly  all  the  towns  are  now  fairly  accessible. 
The  low  belt  of  country  fringing  the  coast  rises  into  plateaus  and 
mountains  of  considerable  elevation  on  proceeding  inland.  A  large 
portion  of  this  veldt  or  elevated  rolling  prairie  is  from  2000  to  5000 
feet  above  the  sea.  The  highest  mountain  in  Cape  Colony,  the  Com- 
passberg,  has  a  height  of  7800  feet. 

Invalids  who  go  to  the  Cape  are  advised  not  to  remain  for  any 
length  of  time  within  one  hundred  miles  of  the  coast  nor  below  an 
altitude  of  1500  feet. 

The  rainy  season  is  in  the  winter  in  the  west  and  southwest,  and 
in  the  summer  in  the  eastern  part  of  the  colony,  where  invalids 
usually  go.  In  the  high  and  more  exposed  regions  the  severity  of 
the  winter  is  the  more  trying,  while  the  ordinary  conveniences  for 
heating  are  absolutely  wanting.  Referring  to  this.  Dr.  Symes 
Thompson  says:  "The  houses  are  usually  built  without  fireplaces, 
and  coal  and  wood  are  almost  unobtainable,  dried  cow-dung  doing 
duty  for  peat,  as  well  as  cement  for  flooring  and  stucco  for  the  walls. " 

The  greatest  drawbacks  to  the  South  African  plains  appear  to  be 
the  winds,  dust,  heat,  and  absence  of  shade,  which  is  much  felt 
during  the  warai  weather,  and  general  scarcity  of  good  water  and 
the  lack  of  suitable  accommodations  for  invalids.  Winter  is  the 
best  time  of  the  year  for  visitors,  who  are  usually  rare  at  that  time, 
as  it  is  then  summer  in  Europe.  The  months  from  February  to 
April,  when  it  is  the  height  of  the  grape  season,  are  pleasant  in 
portions  of  Cape  Colony,  and  tiie  rains  of  late  autumn  and  early 
winter  have  not  commenced. 


AFRICA— ASIA— AUSTRALASIA.  425 

Cape  Town  is  not  recommended  as  a  residence  for  delicate  per- 
sons. The  water-supply  is  inadequate  and  the  drainage  bad,  while 
the  prevailing  wind,  known  as  the  ''Cape  Doctor,"  raises  dust- 
storms  which  rage  furiously  in  the  afternoons.  It  is  a  latitude  sub- 
ject to  frequent  and  heavy  storms,  which  are  less  felt  inland,  where 
the  climate  is  also  more  equable.  The  aunual  rainfall  at  Cape  Town 
is  24  inches;  at  the  attractive  suburb  of  Wynberg,  nine  miles  dis- 
tant, 43  inches;  and  at  Bishop's  Court,  half-way  between  the  other 
two,  57  inches — a  difference  produced  in  each  case  by  the  local  influ- 
ence of  Table  Mountain. 

The  Central  Karoo  district  has  an  average  altitude  of  3000  feet, 
while  the  Upper  Karoo  plateau  ranges  from  2700  to  6000  feet.  The 
climate  of  the  great  or  central  Karoo  is  characterized  by  dryness 
and  prolonged  droughts.  The  annual  rainfall  is  from  9  to  18 
inches  and  the  number  of  rainy  days  is  small.  The  heat  of  sum- 
mer (December,  January,  and  February)  is  intense,  reaching  110°  F. 
in  the  shade ;  but  the  air  is  said  to  be  dry  and  the  nights  cool. 
Thunderstorms  of  great  violence  follow  in  the  wake  of  the  north- 
west winds,  converting  large  tracts  of  country  into  temporary  lakes 
in  a  few  hours,  but  these  storms  are  rare.  The  soil  is  baked  clay, 
usually  utterly  denuded  of  trees.  Snow  appears  in  winter  on  the 
high  mountains,  but  not  in  the  veldt.  The  air  is  clear,  bright,  and 
bracing.  The  most  suitable  stations  in  Cape  Colony  for  pulmonary 
invalids  seem  to  be  as  follows: 

Beaufort  "West  (2792  feet) ;  annual  rainfall,  8  inches  on  25  rainy 
days. 

Lemoenfontein  (3192  feet). 

Aliwal  North  (4318  feet).  Observations  for  four  years  give  an 
annual  rainfall  of  23  inches,  with  89  rainy  days.  This  is  a  large 
village  on  the  Orange  River,  a  stream  which  is  never  dry,  but  runs 
low  for  nine  months  in  the  year.  The  mean  temperature  for  winter 
is  48°  F.;  for  summer,  67°,  with  an  annual  range  from  24°  to  102°, 
Relative  humidity  in  winter,  77  per  cent.;  in  summer,  55  per  cent. 

Burg-hersdorp  (4552  feet),  the  chief  town  of  the  eastern  division 
of  the  Karoo,  is  hot  during  the  summer,  with  cold  winter-nights; 
the  rest  of  the  year  is  delightful.  Principal  rainfall  is  in  the  sum- 
mer. Fogs  are  unknown  on  the  plains,  but  of  frequent  occurrence 
in  the  mountains.     Annual  precipitation,  11  inches  on  41  rainy  days. 

Colesberg  (4407  feet)  has  12  J  inches  of  rainfall  on  33  rainy  days. 

Tarkastad  (4280  feet)  is  not  shut  in  by  hills,  and  has  constant 


426  MEDICAL  CLIMATOLOGY. 

breezes.  It  is  situated  in  a  fertile  region  and  surrounded  by  large 
farms.  It  has  an  average  of  9  inches  annual  rainfall  with  55  rainy 
days. 

Kimberly  (4000  feet  elevation)  is  647  miles  from  Cape  Town  by 
rail  and  485  miles  from  Port  Elizabeth.  It  has  21 J  inches  of  rain- 
fall on  64  rainy  days.  The  mean  temperature  in  winter  is  50°  F. 
and  in  summer  70°.  The  winter  is  short  and  mild.  In  summer, 
although  the  air  in  December,  January,  and  February  may  be  heated 
to  104°  or  105°,  it  is  said  to  be  dry  and  not  oppressive. 

Cradock,  in  the  Karoo  district,  is  recommended  by  Dr.  P.  C. 
De  Wit,  in  the  British  MediGol  Journal,  1894.  The  elevation  is 
2853  feet,  and  many  portions  of  the  district  are  1500  feet  higher. 
It  is  easily  accessible,  but  the  accommodations  for  visitors  are 
poor. 

Bloemfontein,  the  capital  of  the  Orange  Free  State,  with  a  popu- 
lation of  about  3500,  is  the  best-known  health-station  of  the  district. 
It  is  about  the  same  distance  from  Cape  Tovvu  and  Port  Elizabeth 
as  Kimberly.  The  town  is  sheltered  by  neighboring  hills  and  stands 
at  an  elevation  of  4540  feet.  It  is  dry  and  not  very  cold  in  winter, 
while  the  summers  are  long  and  hot.  The  mean  annual  tempera- 
ture is  76°  F.  Mean  minimum  for  winter,  55°.  Mean  maximum 
for  the  six  hot  months,  82°.  The  annual  mean  relative  humidity  is 
55  per  cent.  The  annual  rainfall  is  17  inches  on  70  rainy  days. 
The  town  drainage  is  bad,  but  improvements  are  said  to  be  contem- 
plated. 

Ladybrand  (5000  feet)  has  27  inches  of  rainfall  on  87  rainy 
days.  The  plains  of  the  Orange  Free  State  are  dry,  but  open  and 
dreary. 

Pretoria,  the  capital  of  the  Transvaal  (elevation,  4000  feet;  popu- 
lation, 5000),  is  said  to  be  a  well-sheltered,  attractive  little  town. 
The  surrounding  hills,  which  rise  to  a  height  of  8000  feet,  are  cov- 
ered with  mist  in  the  summer,  yet  the  country  is  said  to  be  healthy; 
the  summers  are  hot.  Pretoria  has  31  inches  of  rainfall  and  64 
rainy  days. 

Johannesburg-  (5000  feet)  is  a  large  place  of  over  20,000  inhab- 
itants, about  forty  miles  south  of  Pretoria,  in  the  gold-mining  district. 

In  Bechuanaland  the  elevation  is  from  4000  feet  to  6000  feet. 
More  rain  falls  than  in  Cape  Colony.  Above  4500  feet  there  is  less 
liability  to  fevers.  It  is  well  not  to  live  near  or  to  leeward  of  newly 
cultivated  or  irrigated  land. 


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From  BUTLEK's  GEOGRAPHIES,  by  permission  of  e.  h.  butler  a  co.    Copyright,  1888. 


AFRICA— ASIA— AUSTRALASIA.  427 

Asia. 

Practically  the  only  portions  of  Asia  which  can  be  regarded  as 
health-resorts  for  Europeans  are  the  mountainous  districts  of  India. 

The  Himalayas,  Through  the  northern  part  of  this  country  run 
the  numerous  ranges  of  the  immensely  high  Himalayan  system, 
which  in  many  ways  characterizes  and  modifies  the  climate.  The 
southern  slopes  of  the  Himalayas  are  dotted,  from  Darjiling  to 
Simlah,  with  hill-stations  ranging  in  elevation  from  4000  to  8000 
feet.  While  this  country  is  much  cooler  than  the  plains,  it  is  sub- 
ject during  the  summer  to  very  heavy  rains,  owing  chiefly  to  the 
influence  of  the  so-called  southwest  monsoons,  which  are  very  damp 
winds  and  bring  a  great  amount  of  moisture. 

It  is  stated  that  fifty  miles  north  of  Dalhousie,  a  British  station 
in  the  North  Punjab,  the  influence  of  the  monsoon  dies  away,  so 
that,  while  no  climatic  records  are  obtainable,  there  is  little  doubt 
that  the  humidity  of  this  section  is  greatly  lessened.  Good,  dry 
health-resorts  could  undoubtedly  be  established  on  the  north  slopes 
of  the  Himalayas;  for  this,  being  the  lee  side  of  the  range, 
receives  only  a  small  amount  of  the  moisture  brought  by  the  mon- 
soon, which,  reaching  first  the  south  slopes  of  the  mountains,  deposits 
upon  them,  as  has  been  said,  the  chief  pait  of  its  burden.  The 
country  on  the  northern  side  is,  however,  too  remote  from  European 
settlements  to  be  at  present  available. 

Kassauli  and  Murree,  and  Dagshai  and  Nynee  Tal  are  stations 
lying  between  Simlah  and  Umballa.  Kassauli  and  Dagshai  are 
used  as  military  sanatoria.  Tiiese  resorts  stand  at  elevations  ranging 
between  6000  and  8000  feet. 

Darjiling,  in  Bengal  (latitude,  27°  north;  elevation,  8200  feet), 
is  one  of  the  best-known  resorts  in  India.  The  town  has  a  popu- 
lation of  about  4000.  It  is  308  miles  north  of  Calcutta,  and  is  much 
resorted  to  in  summer  by  residents  of  the  hot  plains.  There  are 
grand  views  of  the  mountains  on  the  north  and  west.  The  mean 
annual  temperature  is  54°  F. ;  winter,  41°;  summer,  73°.  The 
rainy  season  is  from  June  to  September,  and  the  total  rainfall  is 
stated  to  be  132  inches.  The  mean  annual  atmospheric  pressure  is 
24.058  inches.  During  the  tremendous  summer-rains  the  atmos- 
phere is  very  moist. 

Simlah,  the  hill-metropolis,  is  a  cool  mountain-resort  which,  dur- 
ing the  summer,  is  the  seat  of  the  British  Government.     It  is  also 


428  MEDICAL  CLIMATOLOGY. 

used  as  an  invaliding  station,  is  said  to  be  dry,  and  is  one  of  a  series 
of  stations  of  similar  quality.  It  is  very  gay  during  the  season. 
The  climate  is  characterized  by  an  absence  of  wind  and  a  usually 
cloudless  sky. 

Nilgiri  Hills.  Portions  of  the  Madras  Presidency,  lying  in  the 
Nilgiri  Hills,  inside  the  Western  Ghats,  possess  very  good  resorts, 
having  an  elevation  of  from  5000  to  7000  feet.  The  monsoon, 
striking  the  Western  Ghats  which  form  the  coast-range,  sheds  most 
of  its  moisture  before  reaching  these  hills,  so  that  the  annual  rainfall 
is  only  55  inches — less  than  half  that  of  most  Himalayan  stations. 
It  is  stated  that  the  climate  is  also  more  equable.  The  mean  winter- 
temperature  is  60°  F.;  that  of  summer,  65°.  Occasional  fogs  are 
reported.  Utakamand,  the  summer  capital  of  the  Presidency,  with 
an  elevation  of  7000  feet,  is  situated  in  these  hills. 

Australasia. 

Australasia  has  been  used  by  the  English  for  health-purposes 
especially  on  account  of  the  long  sea-voyage  required  to  reach  it. 
A  description  of  such  a  voyage  and  of  the  meteorological  conditions 
has  been  well  given  by  Dr.  Williams  in  his  Lumleian  Lectures  for 
1893,  when  he  presented  an  instructive  record  and  chart  showing 
the  meteorology  of  a  sailing-voyage  from  England  to  Australia, 
around  the  Cape  of  Good  Hope,  by  a  gentleman  connected  with  the 
British  Meteorological  Office.  Starting  in  October,  ''the  tempera- 
ture ranges  from  53°  to  58°  F.  for  the  first  five  days.  Off  the 
Azores  it  rises  to  60°,  and  passing  Madeira  to  69°.  In  crossing 
the  line  the  maximum,  82°,  is  attained,  but  breezes  are  present  and 
temper  the  heat;  afterward  it  gradually  falls;  in  30°  south  latitude 
70°  F.  is  the  average,  and  this  sinks  to  58°  on  reaching  the  Cape. 
After  rounding  the  Cape  the  temperature,  owing  to  the  mixture  of 
the  warm  Agulhas  current  with  the  antarctic  current,  is  uncertain, 
varying  from  47°  to  56°,  the  currents  overlapping  each  other  and 
causing  great  varieties  of  atmospheric  temperature.  The  vessel 
reaches  43°  south  latitude  and  steers  eastward,  and,  on  account  of 
the  influence  of  the  antarctic  circle,  the  temperature  ranges  from  47° 
to  55°,  and  rises  to  67°  on  approaching  the  continent  of  Australia." 

The  actual  range  of  temperature  on  the  voyage  is  from  47°  to 
82°,  the  number  of  rainy  days  being  about  20.  The  relative 
humidity  varies  from  74  per  cent,  to  91  per  cent.,  the  average  per- 


AFRICA— ASIA— AUSTRALASIA.  429 

centage  being  82.  The  average  length  of  such  a  voyage  is  usually 
from  eighty  to  ninety  days.  If  the  voyage  is  commenced  in  May  or 
June,  the  heat  is  greater  near  the  equator,  and  Australia  is  reached 
in  midwinter.  The  return-voyage  to  England  via  Cape  Horn  is 
not  so  favorable.  ''Near  Cape  Horn  the  temperature  falls  to  41°, 
and  for  several  days  is  often  little  over  43° — a  rather  wretched 
state  of  things.  In  40°  south  latitude  a  rise  of  50°  F.  occurs,  and 
off  Rio  de  Janeiro  78°.  England  is  reached  in  the  early  part  of 
June." 

The  great  objection  to  the  route  via  Suez  is  the  intense  heat  of 
the  Red  Sea,  which  is  overpowering  for  many  invalids. 

Speaking  of  the  voyage  to  New  South  Wales,  Dr.  G.  L.  Mullins, 
of  Sydney,  writes:  "  The  following,  as  a  rule,  bear  the  long  voyage 
and  are  benefited  by  a  sojourn  in  New  South  Wales  :  those  who  are 
predisposed  to  phthisis;  the  scrofulous;  those  in  the  early  stage  of 
phthisis,  with  consolidation  of  the  lung  around  the  tubercle ;  those 
in  whom  the  disease  is  quiescent ;  the  subjects  of  frequent  small 
hemorrhages;  those  with  slight  lung-mischief,  with  irritable  cough 
but  no  fever;  the  anaemic,  or  those  with  defective  appetite;  those 
fairly  free  from  dyspnoea  and  cough  and  able  to  take  exercise. 

"The  following  may  be  considered  unsuitable  and  should  not  be 
allowed  to  travel  so  long  a  distance:  weak,  nervous,  or  excitable 
subjects;  those  who  suffer  severely  from  mal-de-mer;  the  subjects 
of  severe  hemorrhages ;  those  in  the  acute  or  fever  stage;  the  sub- 
jects of  other  organic  diseases  in  addition  to  slight  phthisis  ;  those 
in  whom  the  phthisis  is  advanced  and  the  mischief  still  extending. 

"As  to  the  suitability  of  any  particular  district  in  the  colony,  a 
local  practitioner  should  be  the  judge  in  each  individual  case." 

The  Intercolonial  Medical  Congress,  which  met  at  Dunedin,  New 
Zealand,  in  February,  1896,  adopted  resolutions  to  the  effect  that 
professional  attention  in  England  should  be  directed  to  the  impor- 
tance of  the  nature  of  cases  of  tuberculosis  sent  to  Australia,  and 
that  such  as  are  sent  should  be  directed  to  avail  themselves  of  the 
climates  of  the  interior. 

Australia. 

The  climate  of  the  Australian  seacoast  is  very  variable  at  all  times 
of  the  year,  and  the  air  is  peculiarly  irritating.^ 

>  Winters  Abroad.    R.  H.  Otter,  M.A.,  London,  1882. 


430  MEDICAL  CLIMATOLOGY. 

The  highland  regions  of  Australia  present  a  choice  of  elevations 
from  2000  to  7000  feet,  but  there  are  as  yet  few  accommodations 
for  invalids. 

Regarding  the  value  of  the  climate  of  Australia  for  consumptives, 
an  Australian  correspondent  of  the  Lancet^  recently  referred  to  the 
need  of  sanatoria  in  suitable  locations.  He  stated  that  the  deaths 
from  phthisis  in  each  of  the  colonies  of  Victoria  and  New  South 
Wales  exceeded  a  thousand  a  year,  and  thought  that  there  was 
"■  quite  sufficient  tuberculous  disease  among  the  native-born  popu- 
lation to  keep  such  institutions  well  filled'*. 

''As  a  general  rule,  it  will  be  found  that  a  suitable  climate  will 
possess  the  two  characteristics  of  being  inland  and  having  a  rela- 
tively high  altitude ;  and  this  is  the  case  all  over  the  colonies. 

"In  regard  to  accessibility,  the  diiFerent  places  vary  most  mate- 
rially. The  greater  number  in  Victoria  and  New  South  Wales  are 
accessible  by  rail,  but  often  it  is  a  very  long  journey,  as  to  Hay. 
To  reach  some  places  involves  a  rough  coach-journey.  These,  of 
course,  are  all  points  which  demand  attention.  Places  deserving  a 
trial  are  as  follows:  in  Victoria,  Ballarat,  Geelong,  Echuca,  Mount 
Macedon.  In  New  South  Wales :  Blue  Mountains,  Bathurst, 
Orange,  Hay,  Dubbo,  Blayney.  In  Queensland  the  Darling  Downs. 
I  by  no  means  wish  it  to  be  thought  that  this  list  is  exhaustive."- 

Melbourne,  37°  5'  south  latitude,  lies  at  the  mouth  of  the  Yar- 
row River,  and  is  the  capital  of  the  province  of  Victoria.  It  has  a 
mean  annual  temperature  of  58°  F.,  with  extreme  rangres  during  the 
year  from  111°  to  27°.  The  average  annual  rainfall  is  26  inches. 
The  seasonal  mean  temperatures  are  for  winter,  49.2°;  for  spring, 
57°;  for  summer,  65.3°;  for  autumn,  58.6°.  The  mean  daily  range 
is  22.3°  for  summer,  18.5°  for  autumn,  15°  in  winter,  and  20°  in 
spring.  The  rainfall  on  the  coast  of  New  South  Wales  varies  from 
20  to  50  inches,  with  from  100  to  150  rainy  days. 

Mr.  Otter,  in  a  charming  account  of  his  sojourn  in  Australia,  says 
that  out  of  several  invalids  in  various  stages  of  disease  whom  he  met 
travelling  for.  their  health  the  one  who  had  made  real  progress  had 
spent  most  of  his  time  at  an  elevated  station  in  New  South  Wales. 
He  speaks  very  highly  of  the  station-life  for  invalids. 

Sydney  has  a  mean  annual  temperature  of  62°  F.;  winter,  55°; 
summer,    74°;  the  annual  rainfall  is    48    inches.      The  amount  of 

1  Lancet,  1894,  ii.  p.  57. 

-  G.  A.  Van  Someren,  M.B.C.M.,  in  British  Medical  Journal,  October  10,  1896. 


AFRICA—ASIA— AUSTRALASIA.  431 

rainfall  decreases  steadily  on  going  inland,  wliile  the  temperature 
increases,  rising  to  100°  in  the  shade,  and  in  some  places  to  140°. 
The  hot  north  winds  during  the  summer  are  very  trying,  and  the 
dust  is  so  annoying  that  nearly  all  the  residents  wear  dust-coats  to 
preserve  their  clothing.  To  the  north  of  Sydney  are  the  resorts  of 
Port  Maquaire  and  New  Castle,  and  to  the  south  "Wollong-ong, 
Cape  St.  George,  and  Eden.  There  are  other  stations  lying  at  some 
distance  from  the  sea,  but  on  the  ocean-side  of  the  mountain-range. 

Orang-e,  a  place  of  5000  inhabitants,  lying  about  one  hundred  and 
ninety  miles  west  of  Sydney,  Uas  an  elevation  of  2400  feet  above  the 
level  of  the  sea.  The  mean  annual  rainfall  for  twenty  years  is  38.95 
inches,  distributed  over  101  rainy  days;  but,  although  the  rainfall  is 
large,  the  atmospheric  humidity  is  not  proportionally  high,  and  the 
winter  atmosphere,  although  stimulating  and  tonic,  allows  of  much 
outdoor  life.  The  variation  in  temperature  is  less  during  the  winter 
months  than  at  other  times  of  the  year,  but  the  summers  are  spoken 
of  as  "  never  oppressive".  These  statements  are  on  the  authority  of 
Dr.  Van  Someren,  of  Orange. 

Tasmania. 

This  island,  known  to  an  older  generation  as  Van  Diemen's  Land, 
and  more  especially  defined  in  their  minds  as  a  station  for  trans- 
ported convicts,  lies  south  of  Victoria,  a  i)rovince  of  Australia.  It 
is  reached  from  Melbourne  in  twenty-four  hours  by  the  steamships 
of  the  Australian  Steam  Navigation  Company,  whose  Tasmanian 
port  is  Launceston. 

There  is  no  lack  of  water  in  Tasmania,  and  the  vegetation  is  con- 
sequently luxuriant.  Fruits  fine  as  to  size  and  quality  are  produced, 
and  the  hop-growing  industry  has  become  very  important.  A  very 
good  beer  is  produced  from  these  hops,  lighter  than  the  English 
beer  and  much  esteemed  in  the  colonies.  Mines  of  gold,  iron,  and 
tin  have  been  developed  and  found  to  be  profitable.  Fishing,  rab- 
bit-shooting, and  kangaroo-hunting  are  among  the  attractions  which 
this  island  offers  to  sportsmen,  the  kangaroos  being  hunted  by  means 
of  dogs  especially  bred  to  the  work.    Quail,  duck,  and  snipe  abound. 

The  climate  is  not  extreme,  the  mean  annual  temperature  being 
54°  F.  and  that  of  the  summer  63°,  while  in  the  winter  season  it 
is  46°.  Inland  for  a  short  period  during  the  winter  the  climate 
is  quite  rigorous.  In  summer  the  same  hot  wind  which  blows  in 
Australia  sometimes  visits  Tasmania  also,  but,  on  the  whole,  the 


432  MEDICAL  CLIMATOLOGY. 

island  is  a  valuable  and  cool  summer-retreat,  especially  for  Austra- 
lians. The  annual  rainfall  is  24  inches.  Martin  says  that  at 
Hobart  Town  the  number  of  rainy  days  for  dry  years  is  100  and 
for  wet  years  120.  It  is  said  that  snow  does  not  lie  on  the  plains 
and  valleys  of  the  lowlands,  and  on  the  highest  peaks  only  during 
two  or  three  of  the  winter  months.  The  eastern  part  of  the  island 
is  reputed  dry  and  the  western  rather  wet. 

Hobart  Town,  the  chief  town  of  Tasmania,  is  a  city  of  about 
20,000  inhabitants,  and  is  charmingly  situated  at  the  mouth  of  the 
Derwent  River,  near  Mounts  Wellington  and  Xelson.  It  has  sev- 
eral comfortable  hotels  and  a  small  club,  and  the  social  atmosphere 
is  pleasant.  There  are  walks,  rides,  and  drives  through  the  beauti- 
ful surrounding  country,  and  many  delightful  and  interesting  excur- 
sions may  be  taken,  among  them  one  to  Port  Arthur,  where  live 
such  of  the  convicts  as  have  not  yet  served  out  their  sentences.  The 
drainage  of  Hobart  Town,  however,  is  spoken  of  as  defective. 

New  Zealand. 

New  Zealand  consists  of  two  large  islands  and  one  smaller  one, 
with  the  adjacent  Auckland  and  Chatham  groups.  It  lies  south- 
east of  Australia,  between  latitude  34°  and  47°  south.  Both  of 
the  principal  islands  are  mountainous.  North  Island  having  its 
highest  peaks  in  its  southern  half,  while  in  South  Island  Mount 
Cook,  the  highest  point  of  the  range  which  borders  the  entire 
west  coast,  reaches  an  elevation  of  12,800  feet;  these  have  lately 
been  explored  by  Fitzgerald.  There  are  few  rivers,  although  each 
island  has  one  about  200  miles  long;  but  running  streams  are 
numerous,  so  that  the  islands  are  well  watered.  There  are  many 
lakes,  and  in  North  Island  is  the  well-known  and  beautiful  lake- 
district  where  are  found,  besides  geysers  and  sulphur  springs,  placid 
pools,  like  baths,  containing  warm,  clear  water,  azure  in  hue.  All 
of  these  waters  have  a  reputation  for  the  relief  of  rheumatism,  scor- 
butic affections,  tuberculous  and  nervous  disorders,  and  skin-diseases. 
In  the  Southern  Alps,  which,  as  before  stated,  run  along  the  west 
coast  of  South  Island,  are  a  number  of  lakes,  two  among  them — 
LakesWakatipu  and  Te  Anau — being  especially  notable  for  size  and 
beauty.  The  scenery  of  these  islands  is  grand  and  beautiful  in  an 
unusual  degree. 

The  yearly  rainfall  is  large,  occurring  chiefly  during  the  winter 
season  in  North  Island,  but  being  more  evenly  distributed  through 


AFEICA— ASIA— AUSTRALASIA.  433 

all  seasons  in  South  Island.  Observations  at  Wellington  in  1882 
showed  the  amount  of  rain  for  that  district  to  be  55|  inches,  falling 
on  166  days,  and  the  smallest  record,  that  for  Dunedin  from  1864  to 
1881,  was  34.6  inches.  Droughts  very  rarely  occur,  and  it  is 
humid  throughout  tlie  year.  Dr.  Hector,  in  his  Handbook  of  New 
Zealand,  says: 

"  The  climate  resembles  that  of  Great  Britain,  but  is  more 
equable,  the  extremes  of  daily  temperature  ouly  varying  throughout 
the  year  by  an  average  of  20°  F. ;  while  London  is  7°  colder  than 
the  North  and  4°  colder  than  the  South  Island  of  New  Zealand. 
The  mean  annual  temperature  of  the  North  Island  is  57°  and  of  the 
South  Island  52°,  that  of  Loudou  and  New  York  being  51°.  The 
mean  annual  temperature  of  the  different  seasons  for  the  whole  colony 
is  in  spring,  55°;  in  summer,  63°;  in  autumn,  57°;  and  in  winter, 
48°.  The  climate  on  the  west  coast  of  both  islands  is  more  equable 
than  on  the  east,  the  difference  between  the  average  summer-  and 
winter-temperature  being  nearly  4°  greater  on  the  southeast  portion 
of  the  North  Island  and  7°  on  that  of  the  South  Island  than  on  the 
northwest,  on  which  the  equatorial  winds  impinge.  This  constant 
wind  is  the  most  important  feature  in  the  meteorology  of  New  Zeal- 
and, and  is  rendered  more  striking  by  comparing  the  annual  fluc- 
tuation of  temperature  on  the  opposite  seaboards  of  South  Island, 
which  have  a  greater  range  of  temperature  by  18°  at  Christchurch 
on  the  east  than  at  Hokitika  on  the  west." 

The  prevailing  wind  for  all  districts  and  for  tiie  entire  year  is 
westerly.  The  soil  is  lighter  than  that  of  England  and  more  easily 
worked,  and  it  is  also,  for  the  most  part,  very  fertile.  New  Zealand 
has  about  750  endemic  species  of  flowering  plants.  The  principal 
towns  are  Wellington,  the  seat  of  the  Government,  Auckland, 
and  Christchurch. 


28 


CHAPTER    XIX. 

ISLAND  CLIMATES. 

The  Bermudas. 

This  group  of  islands  lies  600  miles  east  of  the  North  Atlantic 
coast  of  the  United  States,  in  latitude  32°  14'  to  32?  25'  north. 
It  is  less  than  three  days  from  New  York  by  steamer. 

Hamilton  aud  St.  Georges  are  the  principal  towns.  They  are 
provided  with  good  hotels.  There  are  supposed  to  be  365  islands 
in  all,  many  of  them  but  coral-reefs.  The  largest  island,  called 
Great  Bermuda,  is  sixteen  miles  long  by  one  and  a  half  miles  wide. 
The  porous  limestone  rock  that  lies  underneath  the  surface-soil 
readily  absorbs  water.     Rainwater  is  used  for  all  domestic  purposes. 

The  climate  is  moist  and  equable.  The  nights  are  usually  but  3° 
or  4°  cooler  than  the  day.  The  mean  temperature  for  the  year  is 
69°  F.,  with  extremes  from  42°  to  90°.  The  January  mean  is  61°; 
for  July  it  is  79°.  The  coolest  mouth  is  March,  61°;  and  the 
warmest  August,  80°.  The  record  for  two  winters,  1888-'89  and 
1889-'90,  shows  a  mean  monthly  maximum  of  70°  and  a  mean 
minimum  of  51°.  For  the  two  months  of  March  and  April  for 
two  years,  1889  and  1890,  the  mean  maximum  was  72°  and  the 
mean  minimum  55°. 

The  annual  precipitation  is  50  inches.  October  has  the  most 
rain,  and  the  months  from  April  to  June  the  least. 

The  annual  mean  relative  humidity  for  Bermuda  is  80  per  cent. 

The  islands  are  resorted  to  almost  solely  in  winter.  The  summer, 
which  holds  on  late,  is  said  to  be  extremely  debilitating,  with  Avarm 
fogs.     The  prevailing  wind  at  that  season  is  a  damp  southwest  wind. 

The  roads  on  the  island  are  good  and  hard. 

Bermuda  is  an  important  naval  and  military  station  of  Great 
Britain.  It  is  the  headquarters  of  the  North  Atlantic  squadron, 
and  at  Ireland  Island  is  the  largest  floating  dock  in  the  world. 

The  Bahamas. 

The  Bahama  Islands  (latitude,  25°  5'  north)  are  under  the  Eng- 
lish flag  and  have  a  governor  appointed  by  the  Crown. 


ISLAND  CLIMATES.  435 

The  islands  are  of  coral-formation,  covered  with  drift.  Mr.  Stark, 
in  his  guide-book/  says  that  they  are  evidently  formed  on  a  plateau 
of  submarine  mountains  of  great  height.  Soundings  on  the  north- 
east or  ocean-side  of  Eleiithera  Island  show  on  the  charts  a  depth 
of  water  of  12,000  feet  near  the  shore  and  16,000  feet  fifteen  or 
twenty  miles  out. 

The  island  of  New  Providence  is  960  miles  south  (and  somewhat 
west)  of  New  York — a  little  over  three  days  by  steamer  —and  about 
200  miles  east  of  the  end  of  the  Florida  peninsula.  From  Key  West 
the  distance  is  nearly  300  miles.  The  island  is  about  sixteen  miles 
long,  with  an  average  width  of  five  miles. 

Nassau.  The  capital  city  faces  a  harbor  on  the  northern  shore, 
where  the  benefit  of  the  constant  northeast  trade-wind  can  be  felt. 
Its  population  is  placed  at  12,000,  the  negroes  greatly  predomi- 
nating in  numbers.  The  roads  around  the  town  are  very  good, 
being  hard  and  smooth.     There  are  two  good  hotels. 

From  the  harbor  of  Nassau  the  land  rises  steadily  to  a  height  of 
100  feet,  affording  natural  facilities  for  drainage,  but  there  is  no 
town-system  of  sewerage.  The  soil  absorbs  water  rapidly,  and  this 
porous  quality  adds  to  the  danger  from  cesspools  and  vaults.  The 
usual  arrangements  for  water  for  domestic  use  are  frequently  open 
to  criticism.  Rainwater  is  the  best  source  of  supply,  and  great  care 
is  necessary  to  keep  the  cisterns  thoroughly  clean. 

The  residences  are  usually  built  of  limestone,  with  thick  walls. 
Each  house  stands  alone,  surrounded  by  more  or  less  land,  Avith  its 
own  flower-garden  and  fruit-trees. 

The  general  health  of  Nassau  is  very  good.  There  are  large 
marshes  near  the  centre  of  the  island,  which,  although  they  feel  the 
cleansing  influences  of  the  daily  tides,  would  undoubtedly  affect 
injuriously  the  healthfulness  of  the  town  if  winds  from  the  south 
and  west  were  not,  fortunately,  of  extremely  rare  occurrence.  The 
prevailing  northerly  and  easterly  winds,  which  are  quite  steady 
during  the  winter  and  spring,  are  of  great  value  to  the  residents 
on  the  northern  shore  of  the  island. 

Mr.  Drysdale,  in  his  entertaining  collection  of  letters,^  which 
were  first  published  in  a  New  York  paper,  says  :  ''  From  November 
to  June  there  is  no  healthier  place  (than  Nassau).  ...  I  do 
not  see  how  it  could  be  otherwise.     The  island  is  a  solid  rock,  per- 

1  History  and  Guide-book  to  the  Bahama  Islands,  etc.    James  H.  Stark,  Boston,  1891. 
-  In  Sunny  Lands.    William  Drysdale,  New  York,  1885. 


436  MEDICAL  CLIMATOLOGY. 

petually  swept  by  sea-breezes,  and  being  on  it  is  like  being  on  the 
deck  of  a  great  steamer  in  raid-ocean  without  any  sea-sickness.  I 
have  mentioned  before  the  fact  that  tropical  islands  with  rich  soil 
are  generally  unhealthy,  while  the  rocky  islands  built  up  by  the 
industrious  coral  insect  are  always  the  reverse.  No  stretch  of  the 
imagination  could  make  the  soil  of  Nassau  appear  rich,  and  there 
is  nothing  for  sickness  to  build  itself  upon." 

Mr.  Drysdale  quotes  from  the  Nassau  Almanac  a  record  of  the 
mean  monthly  temperature  for  the  year  1878,  taken  at  3  p.m.  (the 
hottest  portion  of  the  day),  which  by  seasons  was  as  follows:  winter, 
73°;  spring,  79°;  summer,  84°;  autumn,  80°.  January  had  an 
average  of  73°;  March,  76°;  July,  86°.  The  mercury  rose  above 
90°  for  three  days  during  the  year.  The  maximum  solar  tempera- 
ture was  in  January,  140°;  March,  149°;  July,  159°. 

A  record  of  the  mean  monthly  temperature  of  Nassau  for  ten 
years,  compiled  from  observations  taken  on  week-days  at  9  a.m.  at 
the  Nassau  Military  Observatory,^  arranged  by  seasons,  is  as  fol- 
lows: winter,  71°;  spring,  75°;  summer,  81°;  autumn,  77°.  The 
monthly  mean  for  January  was  70°;  for  March,  72°;  for  July,  82°; 
annual  mean,  76°. 

Mr.  Stark  reports  the  average  temperature  for  the  winter  months 
as  70°  F. ;  for  spring,  77°  ;  and  says  the  coldest  day  registered  for 
twenty-one  years  was  64°  (which  seems  a  few  degrees  too  high),  and 
the  warmest  day  from  November  to  May  was  82°.  Mr.  Drysdale,  in 
one  of  his  letters  to  the  New  York  Times,  referred  once  to  a  temper- 
ature of  55°,  and  the  writer  has  a  recollection  of  having  seen  the 
thermometer  at  58°  under  the  stone  porch  of  the  hotel  during  a 
cold  rainstorm  one  February.  It  would  therefore  be  wise  for  a 
delicate  invalid  to  take  the  precaution  of  securing  quarters  where  a 
fire  could  be  had  if  needed,  for,  although  frost  is  unknown,  the 
damp  chill  of  a  long,  hard  storm  is  most  penetrating. 

As  is  usual  with  warm  and  humid  marine  climates,  the  annual 
range  of  temperature  at  Nassau  is  limited.  The  mean  annual  baro- 
metric pressure  is  30  inches.  The  average  relative  humidity  for  the 
year  is  79  per  cent.;  for  winter,  83  per  cent.;  for  spring,  76  per 
cent,  (means  for  five  years^).  Taking  the  above  temperature-record 
for  ten  years  as  a  basis,  this  would  show  for  the  year  an  average  of 

1  This  temperature-record  appeared  originally  in  Governor  Ravvson's  report  for  1864.    It  is 
quoted  in  Ives's  Isles  of  Summer  and  Buck's  Handbook  of  the  Medical  Sciences. 

2  Furnished  by  United  States  Weather  Bureau. 


ISLAND  CLIMATES.  437 

7.63  grains  ;  for  winter  of  6,84  grains,  and  for  spring  of  7.12  grains 
of  absolute  humidity  or  vapor  present  in  each  cubic  foot  of  air. 

The  average  rainfall  for  ten  years  was  for  winter,  7.2  inches  ; 
spring,  13.8  inches.  Annual  mean,  56  inches.  The  rainfall  at 
Nassau  during  the  six  months  from  November  to  May  is  usually 
about  one-third  of  the  total  amount  for  the  year. 

The  only  danger  from  hurricanes  is  from  August  to  November, 
and  the  heaviest  and  most  damaging  hurricanes  are  separated  by 
intervals  of  several  years. 

The  most  attractive  occupation  for  a  visitor  is  boating  in  row- 
boats  and  sailing  in  small  craft  to  the  beautiful  Sea  Garden  and  to 
the  white  beaches  and  cocoanut-groves  of  neighboring  semitropical 
islands.  Sea-bathing  is  a  luxury  that  can  be  enjoyed  at  any  time  of 
the  year,  the  temperature  of  the  sea-water  being  usually  in  the  vicinity 
of  70°  F. 

Nassau  has  warmer  winters  than  Bermuda,  the  Azores,  Madeira, 
or  Teneriffe.^  The  air  at  Nassau  appears  to  be  less  moist  and 
muggy  than  that  of  Bermuda. 

The  Royal  Victoria  Hotel  is  built  of  limestone,  four  stories  in 
height,  with  wide  verandas.  It  is  the  finest  hotel  in  the  West  Indies, 
and  has  the  advantage  of  being  less  than  four  days  from  the  markets 
of  New  York.  Beginning  in  January,  1896,  a  steamer  will  run 
regularly  three  times  a  week  during  the  winter  season  from  Palm 
Beach,  Florida,  to  Nassau,  making  the  trip  in  fifteen  hours. 

Bleuthera.  Forty  or  fifty  miles  east  northeast  of  Nassau,  Eleu- 
thera  Island  stretches  its  irregular,  narrow  length  of  seventy  miles  on 
the  Atlantic,  affording  in  a  measure  a  breakwater  for  the  protection 
of  Nassau  from  the  ocean-surges. 

It  is  a  safe  and  delightful  cruise  in  the  lee  of  islets  and  cays  to 
the  tropical  quiet  of  the  settlements  on  Eleuthera  for  those  who  can 
live  for  a  time  without  the  comforts  of  modern  civilization.  The 
best  way  of  seeing  the  islands  leisurely  is  to  charter  a  small  schooner 
with  suitable  accommodations,  with  skipper  and  boy,  ample  pro- 
visions, and  a  cook. 

The  principal  harbor  is  on  the  northeast  of  Eleuthera,  inside  of 
Harbor  Island.  It  is  well  sheltered,  and  can  be  entered  by  vessels 
drawing  less  than  nine  feet  of  water. 

Harbor  Island  is  about  two  miles  long  by  one  mile  wide. 

1  See  Table  XIV. 


438  MEDICAL  CLIMATOLOGY. 

Dunmore  Town,  the  largest  settleiiieut  in  the  Bahamas  next  to 
Nassau,  is  on  the  lee  side  of  the  island,  facing  the  bay.  Mr.  Stark 
gives  its  population  as  2000.  ''A  very  pleasing  little  place  it  is, 
encircled  by  beautiful  cocoanut-groves,  and  sauntering  and  dreaming 
by  its  beautiful  green  waters  in  an  air  of  solitude  and  peace  is  very 
enticing  to  one  who  is  weary  of  the  rush  and  giddy  whirl  of  modern 
life,  while  the  cool  trade- winds  always  moderate  the  heat." 

Besides  Harbor  Island  there  are  in  the  district  of  Elenthera 
eleven  other  settlements,  the  population  of  which  varies  from  a 
dozen  persons  or  thereabout  to  500  or  more. 

Governor's  Harbor,  half-way  down  the  island,  is  one  of  the 
largest  and  most  attractive  settlements,  with  its  churches  and  public 
buildings  on  a  ''cay"  (as  such  a  small  island  or  reef  is  usually 
called),  which  is  connected  with  the  ''mainland"  by  a  causeway 
leading  to  the  foot  of  the  hill.  "The  houses  on  this  hillside  are 
white  and  very  neat  appearing,  each  one  standing  alone  in  its  own 
garden,  and  the  whole  place  having  the  appearance  of  a  beautiful 
tropical  watering-place." 

On  the  ocean-side  of  Elenthera,  a  few  miles  south  of  Harbor 
Island,  is  a  limestone  arch,  eighty-five  feet  above  the  sea,  known 
as  the  "Glass  Window."  In  1872  an  extraordinary  tidal- wave, 
unaccompanied  by  wind,  washed  under  this  arch  and  over  the 
island.  In  this  vicinity  is  also  the  curious  rock-formation  called 
the  "  Cow  and  Bull  "  and  a  limestone  cave  extending  underground 
several  hundred  feet. 

Cocoanuts,  pineapples,  oranges,  lemons,  bananas,  sugar-cane,  figs, 
almonds,  corn,  potatoes,  yams,  tomatoes,  and  melons  are  all  more 
or  less  cultivated  on  the  island  and  shipped  to  Nassau  and  New 
York. 

Jamaica. 

The  island  of  Jamaica  is  about  ninety  miles  south  of  Cuba.  Its 
total  length  is  one  hundred  and  forty  miles,  with  a  width  varying 
from  twenty-nine  to  forty-nine  miles.  It  is  the  largest  and  most 
imj)ortant  of  the  British  West  Indian  possessions.  A  ridge  called 
the  Blue  Mountains  runs  through  the  eastern  end  of  the  island  from 
southeast  to  northwest,  rising  at  the  highest  point  to  a  height  of 
7500  feet. 

The  temperature  in  the  lowlands  of  the  coast  will  average  75°  F. 


ISLAND  CLIMATES.  439 

at  night  and  85°  in  the  day.  New  Castle  (3800  feet)  is  credited 
with  68°  for  the  hottest  month  and  61°  for  the  coldest.  On  the 
highestlevels  it  is  from  40°  to  50°. 

The  healthiest  portion  of  the  island  is  said  to  be  above  an  eleva- 
tion of  1400  feet,  and  the  north  side  of  the  island  is  preferred. 
The  highest  regions  of  the  mountains  have  many  clouds.  In  this 
cool,  moist  region  is  found  vegetation  belonging  to  colder  climates. 
Buck's  Reference  Handbook  of  the  Medical  Sciences  states  that  at 
an  elevation  of  4000  feet  the  temperature  ranges  from  44°  F.  in  the 
winter  to  65°  in  the  summer.  The  difference  in  temperature  be- 
tween the  north  and  south  sides  of  the  island  is  about  5°  for  the 
year  and  from  8°  to  10°  during  the  first  three  months. 

The  mean  annual  rainfall  of  the  island  for  five  years,  according 
to  the  Handbook,  was  50  inches  on  116  days. 

One  of  the  healthiest  portions  is  the  parish  of  St.  Ann,  which  is 
in  the  centre  of  the  northern  side  of  the  island.  The  mean  annual 
temperature  is  76°  F. 

The  inland  village  of  Moneag-ue  (950  feet)  has  a  small  hotel. 
The  roads  in  this  vicinity  are  good. 

Mandeville  (2500  feet)  is  a  pleasant  town  in  the  coffee  and 
grazing  country.      It  has  a  good  hotel. 

The  Santa  Cruz  district  has  also  a  healthy  climate. 

The  rainiest  portion  of  Jamaica  is  naturally  at  the  northeast  end, 
facing  the  trade-wind.  Hurricanes  may  occur  between  July  and 
October. 

The  population  of  the  island  in  1891  was  640,000,  of  which 
about  15,000  were  white. 

Kingston,  the  capital  of  the  island  of  Jamaica,  is  situated  in  lati- 
tude 17°  58'  north.  Population,  50,000.  The  city  is  regularly  laid 
out  on  a  gently  sloping  plain  on  the  south  coast  near  the  east  end  of 
the  island,  at  the  foot  of  the  Blue  Mountains,  the  loftiest  ridge  being 
to  the  northeast  of  the  plain.  The  harbor  of  Kingston  is  one  of 
the  best  in  the  West  Indies.  The  town  is  commonplace,  with 
unpaved  streets,  frame  buildings,  and  few  trees.      It  is  always  hot. 

The  soil  on  which  Kingston  is  built  is  gravel,  sloping  to  the  harbor 
and  offering  natural  opportunities  for  drainage  that  are  sadly  neg- 
lected. The  water-supply  is  drawn  from  two  rivers  several  miles 
above  the  city,  and  is  considered  good.  The  town  is  lighted  by  elec- 
tricity and  has  a  tramway.     The  new  Hotel  Kio  Cobre  is  fifteen 


440 


MEDICAL  CLIMATOLOGY. 


miles  north  of  Kingston.  The  island  of  Jamaica  has  an  equable, 
hot,  and  moist  climate. 

The  mean  annual  temperature  of  Kingston  (ten  years'  records) 
is  78°  F.  Mean  relative  humidity,  78  per  cent.  Mean  absolute 
humidity,  8.02  grains  of  vapor  to  the  cubic  foot.  Wiud-movement 
for  the  year  a  little  over  3  miles  per  hour  from  the  southeast.  Dur- 
ing the  winter  it  is  about  4  miles  and  during  the  summer  2f  miles 
per  hour.  The  mean  of  annual  precipitation  is  32J  inches,  the  greatest 
rainfall  being  in  May  and  June  and  August,  September,  and  Octo- 
ber. The  least  rain  falls  from  November  to  April.  The  mean  of 
the  rainfall  for  the  i.sland  of  Jamaica  for  the  year  1893  was  8Q^ 
inches. 

The  following  seasonal  meteorological  table  for  Kingston  is 
adapted  from  a  valuable  table  compiled  by  Maxwell  Hall,  M.A., 
F.R.A.S.,  F.R.M.S.,  published  in  the  Handbook  on  Jamaica,  pre- 
pared by  the  Honorary  Commissioner  for  Jamaica  to  the  World's 
Fair  at  Chicago  in  1893,  Lieutenant-Colonel  the  Honorable  Charles 
J.  Ward,  C.M.G. 

Table  IV. — Kingston,  Jamaica. 
For  the  ten  years  from  June,  1880,  to  May,  1890. 


Temperature. 

Cloudi- 
ness; 
per  cent, 
of  whole 
sky. 

Wind; 

Total  rainfall. 

Relative 

Absolute 

miles 

Monthly  mean. 

Mean 

Max. 

Min. 

humidity 

humidity 

per 
day. 

Kings- 
ton. 

The 
Island. 

Per  cent. 

Grains. 

Inches. 

Inches. 

Winter  .... 

74° 

86° 

67° 

78 

7.07 

31 

65 

2.78 

12.09 

Spring  .... 

76 

86 

70 

76 

7.34 

41 

73 

9.11 

15.46 

Summer     .    .    . 

80 

89 

73 

77 

8.42 

.53 

99 

11.75 

18.98 

Autumn     .    .    . 

78 

89 

72 

79 

8.12 

54 

59 

8.90 

19.77 

Annual      .    .    . 

78 

88 

71 

78 

8.02 

44 

74 

32.54 

66.30 

Temp>erature,  maxima  and  minima,  hased  on  monthly  means,  not  oa  the  extreme  readings. 
The  above  figures  represent  the  monthly  means,  except  for  the  rainfall,  which  is  total. 


Barbados. 

Barbados  is  the  most  eastern  of  the  Caribee  Islands  under  the 
English  flag.  It  is  situated  in  18°  4'  north  latitude  and  59°  37' 
west  longitude.  Authorities  do  not  agree  as  to  its  size,  but  it  is 
nearly  eighteen  miles  long  by  twelve  miles  wide.  It  is  seven  days 
from  New  York  by  direct  passage  on  the  Brazil  line,  and  about  two 


ISLAND  CLIMATES.  441 

weeks  by  steamers  stopping  ou  tlie  way  at  other  islands.  Landing 
is  made  on  the  leeward  or  southwest  side  of  the  island,  on  the  shores 
of  an  open  roadstead  called  Carlisle  Bay,  where  the  town  of  Bridge- 
town is  located.  The  Marine  Hotel — an  excellent  structure  built 
by  the  Government — is  at  Hastings,  two  and  one-half  miles  east  from 
Bridgetown,  connected  by  tramway.  The  soil  is  coral  and  limestone 
rock.  It  is  quite  bare  of  trees.  The  greatest  elevation  is  1200 
feet  ou  the  eastern  side  of  the  island.  The  healthiest  residence- 
portion  of  the  island  is  in  what  is  called  Scotland.  Residence  in 
Bridgetown  is  to  be  avoided. 

Barbados  has  a  moist  but  salubrious  climate,  without  rains  or 
heavy  dews  during  what  is  called  the  ''dry  "  or  rainless  season,  from 
December  to  May.  It  will  average  several  degrees  warmer  during 
the  winter  than  Nassau.  Its  blandness  and  equability  of  tempera- 
ture are  suited  to  a  certain  class  of  invalids,  as  there  are  no  sudden 
or  dangerous  changes.  The  northeast  trade- wind  blows  steadily 
during  the  day;  occasionally  it  is  unpleasantly  strong.  The  air  is 
pure  and  healthy.  Temperature  ranges  from  76°  F.  at  night  to  83° 
for  the  day  during  the  winter  months.  The  mean  for  January  is 
76°  and  for  August  80°.  The  rainy  season  is  from  June  to  Novem- 
ber, when  the  island  is  also  liable  to  be  visited  with  hurricanes. 
August  and  October  are  usually  the  rainiest  months.  The  annual 
rainfall  is  about  57  inches,  of  which  about  2  inches  fall  in  March, 
the  driest  month,  and  11  inches  in  October,  the  dampest.  The  mean 
annual  relative  humidity  is  72  per  cent.  The  mean  for  winter  is 
the  same,  72  per  cent.^ 

The  sea- water  temperature  is  about  78°  F.,  and  delightful  for 
bathing. 

The  population  of  the  island  is  estimated  at  182,000,  of  which 
15,000  are  white,  the  rest  African. 

Barbados  is  one  of  the  most  thickly  populated  places  in  the  world, 
there  being  an  average  of  1100  persons  to  each  square  mile.  There 
is  a  railway  which  renders  most  of  the  island  accessible. 

The  principal  industry  is  the  cultivation  of  sugar-cane. 

The  Azores. 

The  nine  islands  called  the  Azores  are  two  thousand  miles  from 
Boston  and  over  eight  hundred  miles  from  the  coast  of  Portugal,  to 

1  Humidity  deduced  from  observations  by  the  Royal  Engineers.    Means  for  eight  years. 
Obtained  through  the  courtesy  of  U.  S.  Weather  Bureau. 


442  MEDICAL  CLIMATOLOGY. 

wliich  country  they  belong.  They  are  of  volcanic  origin,  and  have 
suffered  from  infrequent  earthquakes  of  great  violence.  They  are 
rugged  and  picturesque,  with  precipitous  coast-lines,  rising  toward 
the  interior  to  an  average  height  of  3500  feet.  On  the  island  of 
Pico  is  a  peak  7600  feet  above  sea-level,  and  extending  below  to  a 
depth  of  1600  feet. 

There  are  no  natural  harbors;  large  vessels  anchor  in  the  open 
roadstead  off  the  principal  ports.  A  breakwater  is  being  constructed 
off  Ponta  Delgada  that  is  supposed  to  be  capable  of  protecting  one 
hundred  vessels  of  all  sizes. 

The  islands  are  reached  by  steamer  from  Xew  York,  and  by  a 
regular  sailing  packet — the  barque  "  Sarah  " — from  Boston. 

There  are  mail  steamers  to  Lisbon  twice  a  month  and  fruit 
steamers  to  London,  as  well  as  ships  putting  in  constantly  for  sup- 
plies or  repairs. 

Sao  Miguel  or  St.  Michael's,  the  largest  island  of  the  group,  is 
over  forty  miles  long  and  from  five  to  twelve  miles  wide.  A  pamphlet 
by  Dr.  Emerson  Warner,  of  \yorcester  (Mass.),  descriptive  of  the 
islands,^  says  the  population  of  the  principal  town,  Ponta  Delgada 
(latitude,  37°  45'  north),  is  25,000.  The  city  is  situated  on  the 
southwest  side  of  the  island,  and  extends  along  the  shore  for  two 
miles.  The  streets  are  straight  and  broad.  The  houses  are  built 
of  basaltic  lava.  Stoves  are  seldom  seen,  tires  being  used  by  the 
natives  for  cooking-purposes  only. 

Hotel -accommodations  are  limited,  and  are  mostly  under  Portu- 
guese management.  There  is  a  small  hotel  in  Ponta  Delgada  kept 
bv  an  English  family.  At  Fayal  is  a  Portuguese  hotel  of  some 
pretensions.     The  expenses  of  living  are  moderate. 

The  roads  are  good.  In  the  larger  cities  are  fairly  comfortable 
carriages,  usually  drawn  by  mules,  but  in  the  country  the  donkey  is 
the  chief  beast  of  burden. 

The  highest  point  on  St.  Michael's  is  on  the  west  and  has  an 
elevation  of  3060  feet.     The  plains  are  fertile. 

Hot  springs  abound  in  St.  Michael's.  A  palatable  table-water  is 
bottled  on  the  island  and  offered  for  sale.  In  the  lovely  valley  or 
crater  of  the  Furnas,  twenty-seven  miles  from  Ponta  Delgada,  are 
many  hot  mineral  waters,  A  large  bath-house  and  small  hospital 
adjoining  have  been  built  for  the  use  of  patients.  Springs  of  fresh 
water  are  plentiful  on  the  islands. 

1  The  Azores  as  a  Resort.    Emerson  Warner,  M.D. 


ISLAND  CLIMATES.  443 

On  the  island  of  Fayal  the  principal  town  is  Villa  de  Horta 
(latitude,  38°  30'  north)  ;  population  about  8000.  This  port  trades 
largely  with  America,  while  Pouta  Delgada  is  in  more  direct  com- 
munication with  England. 

The  Azores  have  an  equable  climate.  The  mean  annual  tempera- 
ture is  62°  F.  The  extremes  are  stated  to  be  ^6°  and  45°.  The 
range  between  winter  and  summer  is  from  10°  to  15°.  The  night- 
temperature  is  ordinarily  not  more  than  4°  cooler  than  the  day. 
The  summer  is  enervating  at  70°;  one  is  drenched  with  perspiration 
on  the  slightest  exertion.^ 

The  mean  temperature  for  winter  is  58°,  for  spring  61°,  for  sum- 
mer 68°.  The  three  coldest  months  are  usually  January,  February, 
and  March. 

In  winter  it  sometimes  feels  chilly  and  damp,  and  one  seldom 
leaves  home  without  an  umbrella.  The  climate  is  very  humid. 
AYall-paper  will  not  adhere,  and  the  veneering  of  furniture  strips 
off.  The  mean  annual  relative  humidity  is  76  per  cent.,  and  for 
winter  it  is  77  per  cent. 

The  mean  annual  rainfall  is  38|^  inches. - 

The  winds  blow  with  great  force  at  times  and  there  are  frequent 
storms.  The  prevailing  direction  of  the  wind  in  winter  is  from  the 
south,  southwest,  and  northwest,  and  in  summer  from  the  northeast, 
east,  and  north.      (See  Table  XIV.) 

The    Madeiras. 

Madeira  Island,  the  largest  of  the  group  of  that  name,  is  about 
thirty  miles  long  by  thirteen  miles  wide.  It  is  traversed  by  a  moun- 
tain-chain running  its  entire  length  from  east  to  west.  Near  the 
middle  is  the  highest  peak,  6100  feet.  The  northern  and  southern 
sides  of  the  momitains  are  broken  by  deep  ravines  watered  by  limpid 
streams.  On  the  slopes  are  gardens  and  vineyards.  The  soil  is 
fertile.  The  islands  are  of  volcanic  origin,  but  earthquakes  are 
rare.  Deep-sea  soundings  show  them  to  be  the  peaks  of  lofty 
submarine  mountains.  The  inhabitants  are  of  Portuguese  descent, 
with  some  admixture  of  Moorish  and  negro.  The  population  of  the 
island  is  132,000.     The  wine  of  Madeira  has  always  been  famous. 

1  A  Summer  in  the  Azores.    C.  Alice  Baker,  Boston,  1882. 

2  Records  of  iiumidity  and  rainfall  furnished  by  kindness  of  U.  S.  Weather  Bureau.  Records 
for  Azores  for  four  years,  for  Madeira  for  five  years. 


444  MEDICAL  CLIMATOLOGY. 

Funchal  (latitude,  32°  38'  north;  population,  20,000),  the  capital 
of  Madeira,  is  picturesquely  situated  oa  the  south  coast  of  the  island, 
on  an  open  bay  or  roadstead,  from  which  the  mountains  rise  behind 
the  town  to  a  height  of  4000  feet.  Funchal  is  360  miles  from 
the  coast  of  Africa,  535  miles  from  Lisbon — with  which  it  is  con- 
nected by  the  Brazilian  cable — and  1215  miles  from  Plymouth.  It 
has  communication  by  steamer  with  Liverpool  (four  days),  London, 
and  Plymouth,  Antwerp,  Lisbon  (two  days),  Brazil,  Cape  of  Good 
Hope  (five  days),  the  Cape  Verde  Islands,  Azores,  aud  Canaries 
(one  and  a  half  days). 

The  streets  of  Funchal  are  narrow,  but  fairly  clean.  They  are 
paved  with  cobblestones,  are  without  sidewalks,  and  are  lighted  at 
night  by  oil-lamps.  The  shops  are  poor.  Food-supplies  are  said 
to  be  good  except  the  mutton,  which  is  execrable.  Wheeled  vehicles 
are  hardly  ever  used  by  the  natives — not  even  wheelbarrows.  The 
town  has  two  public  walks  bordered  with  trees  and  flowers.  There 
is  plenty  of  excellent  water. 

There  are  good  English  hotels,  and  quintas^  can  be  rented  fur- 
nished. There  is  a  good  English  club  and  library.  There  are  no 
amusements  except  riding  and  being  carried  in  hammocks  through 
the  beautiful  scenery.  Both  English  and  French  are  generally 
understood.     There  is  good  fishing,  but  no  shooting. 

Madeira  has  long  been  noted  for  its  soft,  damp  air  and  equable 
temperature.  It  was  formerly  held  in  high  repute  as  a  resort  for 
consumptives.  The  mean  annual  temperature  is  05°  F. ,  for  winter 
60°.  The  coldest  months  are  January,  February,  and  March,  and 
the  hottest  August  and  September.  The  extreme  range  of  tem- 
perature is  from  90°  to  46°,  which  is  the  lowest  record.  The  tem- 
perature of  the  sea-water  in  winter  ranges  from  61°  to  72°. 

The  mean  annual  rainfall  is  27  inches,  with  extremes  for  different 
years,  as  high  as  49  inches  and  as  low  as  16  inches.  The  greatest 
amount  of  rain  falls  from  November  to  March.  There  is  little  rain 
during  the  summer,  but  the  vegetation  is  freshened  by  dews.  In 
winter  snow  occasionally  falls  on  the  mountain-peaks. 

The  mean  annual  relative  humidity  is  Q(i  per  cent.;  for  winter  it 
is  also  QQ  per  cent.  There  are  no  cold  winds,  but  occasionally  a 
hot  and  dry  east  wind — the  teste — is  felt  from  the  distant  desert. 

1  Quintas,  the  name  for  pleasant  villas  in  their  own  gardens,  the  rent  being  three  hundred 
dollars  a  year  and  upward. 


ISLAND  CLIMATES.  445 

The  opposite,  or  west  wiud,  usually  brings  rain.  The  prevailing 
winds  are  from  the  north,  northeast,  or  northwest.  (See  Table 
XIV.,  for  seasonal  details.) 

The  Canaries. 

The  Canary  Islands,  which  are  under  the  Spanish  flag.  He  sixty 
miles  east  of  the  coast  of  Africa,  in  the  main  current  of  the  Gulf- 
stream  and  in  the  line  of  the  trade-winds.  There  are  seven  inhab- 
ited islands  and  a  few  uninhabited  islets. 

Island  of  Teneriffe.  It  is  said  that  nearly  one  thousand  steamers 
call  at  Teneriffe  duriug  the  year,  rendering  it  particularly  accessible 
from  European  ports.  The  time  from  England  by  steamer  is  from 
four  and  one-half  to  six  days.  Communication  can  also  be  had 
with  Portugal  and  Spain.  There  is  a  good  hotel  on  the  island. 
The  island  of  Teneriffe  is  described  by  Dr.  G.  V.  Perez,^  of  Oro- 
tava,  as  sixty-seven  miles  long,  sixty  miles  being  its  greatest  width 
and  sixteen  miles  its  smallest.  The  peak  is  very  near  latitude  28° 
north,  and  rises  12,000  feet  above  the  sea.  It  is  usually  partly 
obscured  by  a  cap  or  '^parasol"  of  clouds,  about  1000  feet  thick, 
which  begins  at  an  elevation  of  3500  feet.  This  cloud  forms  during 
the  forenoon  and  remains  until  blown  away  by  the  south  wind  that 
arises  in  the  afternoon. 

Orotava  is  the  capital  of  Teneriffe.  It  has  one  good  hotel  in  the 
port  and  a  larger  one  higher  up  in  the  valley.  The  valley  or  amphi- 
theatre of  Orotava  rises  from  the  harbor  of  Port  Orotava  on  the  sea 
to  an  elevation  of  2000  feet.  The  hills  shelter  it  on  all  sides  except 
to  the  north,  which  gives  the  benefit  of  the  pure  ocean-breeze.  The 
'^trades"  begin  to  blow  between  9  and  10  a.m.,  dying  away  be- 
tween 1  and  2  p.m.  At  sunset  the  south  land-breeze  begins  and 
continues  throughout  the  night.  The  cloud  "  parasol  "  that  covers 
the  higher  portion  of  the  island  tempers  the  strength  of  the  sun's 
rays  and  furnishes  shade  for  the  upper  part  of  the  valley.  Toward 
the  seashore  there  is  more  sun  at  midday  than  there  is  higher  up. 
During  the  summer  the  trade-winds  blow  more  strongly  than  in 
winter,  and  the  ^'parasol"  then  appears  more  regularly. 

Above  the  cloud-layer  the  climate  presents  great  extremes,  ranging 
in  July  from  83°  to  28°  F.  The  air  is  much  drier,  the  difference 
between  the  dry  and  wet  bulbs  even  amounting  to  30°,     The  wind 

1  Orotava  as  a  Health-resort.    George  V.  Perez,  M.D. 


446  MEDICAL  CLIMATOLOGY. 

which  blows  from  the  northeast  on  the  shore  of  the  island,  at  au 
altitude  of  over  10,000  feet  blows  from  the  west  and  southwest. 

Orotava  has  an  average  temperature  for  January  of  60°  F.;  for 
July,  of  73°.  Mean  annual  temperature  67 °y  with  an  average 
annual  range  of  14°.  The  temperature  is  said  rarely  to  rise  above 
82°.  By  seasons  it  is  as  follows:  winter,  60°;  spring,  65°;  summer, 
72°;  autumn,  70°. 

From  May  to  August  there  is  no  rainfall.  The  annual  precipi- 
tation is  13  inches.  Average  number  of  rainy  days,  51  ;  the 
rain  most  frequently  falls  in  the  night.  The  average  percentage 
of  relative  humidity  is  at  9  a.m.,  Qb;  2  p.m.,  60;  9  p.m.,  72.  Mean 
annual  relative  humidity,  66  per  cent.  The  record  for  temperature 
and  humidity  is  for  two  years.  The  temperature  of  the  sea-water 
is  lowest  in  March,  64°  ;  highest  in  July,  68°. 

The  climate  of  Orotava  is  equable,  moderately  damp,  and  rather 
relaxing,  while  the  island  has  this  great  advantage,  that  higher 
elevations  and  drier  air  are  obtainable,  if  desired.  The  extraordi- 
nary luxuriance  and  profusion  of  vegetable  growth  are  evidence  not 
only  of  the  equability  of  the  climate,  but  also  of  its  humidity- 
Oranges,  figs,  pineapples,  bananas,  dates,  etc.,  are  found  on  the 
island,  but  not  cocoanuts  or  breadfruit.  The  air  is  said  to  be  rich 
in  ozone.  The  water-supply  is  from  tunnels  bored  into  the  sides 
of  the  mountains,  and  is  reputed  to  be  very  good.  The  soil  is 
porous  and  dries  rapidly  after  rain. 

The  editor  of  the  British  Jledical  Journal,  Dr.  Ernest  Hart,^  says 
that  Orotava  is  not  troubled  by  heavy  dews,  frosts,  siroccos,  mias- 
mas, extreme  heats,  or  even  mosquitoes.  Dr.  Perez  recommends  the 
regions  of  the  Canadas,  at  an  elevation  of  7000  feet,  as  a  site  for  a 
sanitarium. 

The  Hawaiian  (or  Sandwich)  Islands. 

These  islands  are  twenty-one  hundred  miles  southwest  from  San 
Francisco,  and  are  usually  reached  by  steamer  in  six  and  a  half  or 
seven  days.  By  sailing-vessel  the  time  may  be  eighteen  days.  The 
group  is  made  up  of  eight  inhabited  islands. 

Honolulu  (latitude,  21°  18'  north  ;  population,  25,000)  is  situated 
on  the  southern  shore  of  the  island  of  Oahi,  on  a  deep  and  spacious 
bay.     The  city  is  sheltered  by  mountains  from  some  of  the  trade- 

1  A  Winter  Trip  to  the  Fortunate  Islands.    Ernest  Hart,  in  British  Medical  Journal,  1887. 


ISLAND  CLIMATES.  447 

winds  and  from  much  of  the  rainfall  of  the  windward  coast.  Hono- 
lulu is  laid  out  on  a  level  plain  about  25  feet  above  the  sea,  and 
claims  a  good  system  of  municipal  government;  broad,  clean  streets 
lined  with  beautiful  homes ;  many  churches,  a  theatre,  street  rail- 
ways, electric  lights,  telephones,  and  a  town  water-system,  besides 
artesian  wells.  While  the  soil  is  of  a  volcanic  nature  and  fertile 
when  well  watered,  it  is  porous  and  dries  quickly  after  rains.  The 
town  possesses  a  large  hotel  with  adjoining  cottages  aud  other  hotels 
and  boarding-houses. 

At  "Waikiki,  a  seaside-resort  a  few  miles  east  of  Honolulu,  there 
is  fine  surf-bathing.  There  is  a  hotel  at  Waikiki,  and  the  shore  is 
lined  with  villas  and  cottages. 

The  island  of  Oahi  is  thirty-five  miles  long  by  twenty-one  miles 
wide.  A  peak  in  the  western  range  of  mountains  reaches  a  height 
of  over  4000  feet.  On  the  eastern  shore  there  is  a  lower  range  of 
mountains  running  northwest  and  southeast,  which  offers  its  sides 
directly  at  right-angles  to  the  northeast  trade-wind.  On  the  slopes 
of  all  these  mountains  are  beautiful  valleys,  with  deep  ravines,  cas- 
cades, and  luxuriant  tropical  vegetation.  The  mean  annual  tem- 
perature at  Honolulu  is  74°  F.  The  lowest  record  in  the  Government 
Survey  series  for  ten  years  was  54°  and  the  highest  89°.  The 
average  midday  maximum  is  about  80°.  The  greatest  daily  range 
of  temperature  was  23°. 

The  normal  record  by  seasons  for  Punahou,  a  station  near  Hono- 
lulu, is  as  follows:^ 

Temperature. 
Winter  .        .         .     70° 

Spring  .  .73 

Summer  .  .  .77 
Autumn  .  .  .76 
Year     ....     74 

The  average  absolute  humidity  is  for  the  year  6.63  grains,  and 
for  winter  5.91  grains  of  vapor  to  each  cubic  foot  of  air. 

The  wind-movement  at  Honolulu  is  from  3  to  4  on  the  Beaufort 
scale — which  indicates  a  breeze  from  18  to  23  miles  per  hour. 

The  mean  barometric  pressure  for  fourteen  years  was  30.038  inches. 
The  annual  mean  of  cloudiness  for  four  years  expressed  in  tenths  is 
4.22. 

1  From  reports  of  Prof.  C.  T.  Lyons,  in  charge  of  Weather  Bureau,  Honolulu. 


a,tive  humidity. 

Rainfall. 

74perct. 

12.4  inches. 

74       " 

9.9      " 

69       " 

5.7       " 

71       " 

9.8       " 

72      " 

37.8       " 

448  3IEDICAL  CLIMATOLOGY. 

A  very  good  illustration  of  the  varying  quaDtity  of  rain  regis- 
tered in  different  rain-gauges  not  far  from  each  other,  but  exposed 
under  different  conditions,  is  shown  in  the  report  of  Prof.  C.  T. 
Lyons  for  1890.  In  the  showing  of  comparative  rainfall  the  table 
for  the  year  1889  presents  the  records  from  four  reporters  residing 
on  different  streets  in  Honolulu,  showing  totals  for  the  year  ranging 
from  18  to  25  inches,  a  difference  of  7  inches  in  the  same  town.  In 
the  same  report  is  given  a  record  of  rainfall  in  Honolulu  kept  by 
Dr.  R.  McKibbin  for  thirteen  years,  showing  an  annual  mean  of 
30.1  inches,  and  a  record  kept  by  Mr.  W.  W.  Hall  for  sixteen 
years  (including  the  same  thirteen  years),  showing  an  annual  mean 
of  39.5  inches. 

Points  of  small  annual  precipitation  are  Mahukona,  Kawaihae, 
and  South  Kona,  all  on  the  west  coast  of  the  island  of  Hawaii. 

Ha"waii,  the  largest  island  of  the  group — one  hundred  miles 
long  by  ninety  miles  wide — is  nearly  two  hundred  miles  southeast 
from  Honolulu.  It  has  the  great  volcanic  peaks  Mauna  Kea  (13,953 
feet)  and  Mauna  Loa  (13,760  feet).  On  the  southern  side  of  the 
latter,  at  an  elevation  of  4000  feet,  is  the  famous  active  crater  of 
Kilauca,  fourteen  miles  from  the  sea  and  thirty  miles  south  of  the 
port  of  Hilo.      There  is  a  hotel  at  the  volcano. 

The  annual  rainfall  at  Hilo  is  said  to  average  144  inches  a  year. 
The  tropical  verdure  is  unusually  rich  on  this  side  of  the  island. 

West  of  the  great  peaks  the  town  of  Kona,  on  the  west  coast,  and 
Waimea,  which  is  further  inland,  are  reported  to  have  climates  with 
comparatively  low  temperatures  and  less  moisture  than  the  wind- 
ward coast. 

Between  the  two  peaks  is  a  desert-plain  lying  at  an  elevation  of 
5000  or  6000  feet.  It  is  entirely  destitute  of  water  and  has  not  even 
a  trail. 

The  Hawaiian  Islands  are  in  about  the  same  parallels  of  latitude 
as  the  south  coast  of  Cuba.  The  climate  is  equable,  warm,  and 
moist.  Compared  with  Teneriffe  the  island  of  Hawaii  is  larger, 
and  its  two  j^eaks  rise  nearly  2000  feet  higher  from  the  level  of  the 
sea  into  the  region  of  cold  and  snowstorms  ;  it  is  further  south, 
and  on  the  coast  has  a  warmer  average  of  temperature.  The  great 
elevation  affords  the  possibility  of  an  unusual  range  of  climate,  but 
there  is  no  elevated  interior  valley  on  the  protected  western  slope 
which  is  known  to  possess  the  natural  advantages  of  the  valley  of 


ISLAND  CLIMATES.  449 

Orotava,  and,   although  such  a  spot  may  exist,  it  is  not  as  yet 
within  easy  reach  of  necessary  suppHes. 


A  Voyage  upon  Southern  Seas. 

The  vahie  of  the  climate  of  the  Pacific  Ocean  has  been  brought 
into  prominence  of  recent  years  by  the  example  of  that  distinguished 
writer,  the  late  Robert  Louis  Stevenson,  in  seeking  an  asylum  within 
its  influence.  In  his  romance,  The  WrecJcer,  occurs  a  reference  to 
this  sea-life,  in  which  a  personal  note  can  perhaps  be  detected.  It  is 
when  the  adventurers  are  fairly  started  in  the  schooner  "  Norah 
Creina,"  in  search  of  the  wreck  of  the  "  Flying  Scud."  The  pas- 
sage is  as  follows: 

"  I  love  to  recall  the  glad  monotony  of  a  Pacific  voyage,  when 
the  trades  are  not  stinted  and  the  ship  day  after  day  goes  free 
the  deliberate  world  of  the  schooner,  with  its  unfamiliar 
scenes,  the  spearing  of  dolphin  from  the  bowsprit  end,  the  holy 
war  on  sharks,  the  cook  making  bread  on  the  main  hatch:  reefing 
down  before  a  violent  squall,  with  the  men  hanging  out  on  the  foot- 
ropes,  the  squall  itself,  the  catch  at  the  heart,  the  opened  sluices  of 
the  sky,  and  the  relief,  the  renewed  loveliness  of  life,  when  all  is 
over,  the  suu  forth  again,  and  our  out-fought  enemy  only  a  blot 
upon  the  leeward  sea.  .  .  .  Day  after  day  in  the  sun-gilded 
cabin  the  whiskey  dealer's  thermometer  stood  at  84°.  Day  after 
day  the  air  had  the  same  indescribable  liveliness  and  sweetness,  soft 
and  nimble,  and  cool  as  the  cheek  of  health.  Day  after  day  the 
sun  flamed;  night  after  night  the  moon  beaconed  or  the  stars  paraded 
their  lustrous  regiment.  I  was  aware  of  a  spiritual  change,  or  per- 
haps rather  a  molecular  reconstitution.  My  bones  were  sweeter  to 
me.  I  had  come  home  to  my  own  climate,  and  looked  back  with 
pity  on  those  damp  and  wintry  zones  miscalled  the  temperate. 

"^  '  Two  years  of  this,  and  comfortable  quarters  to  live  in,  kind  of 
shake  the  grit  out  of  a  man,'  the  captain  remarked ;  '  can't  make  out 
to  be  happy  anywhere  else.  A  townie  of  mine  was  lost  down  this 
way,  in  a  coal-ship  that  took  fire  at  sea.  He"  struck  the  beach  some- 
where in  the  Navigators,  and  he  wrote  to  me  that  when  he  left  the 
place  it  would  be  feet  first.  He's  well-off,  too,  and  his  father  owns 
some  coasting-craft  down  East;  but  Billy  prefers  the  beach  and  hot 
rolls  off  the  breadfruit  trees.' 

29 


450  MEDICAL  CLIMATOLOGY. 

"A.  voice  told  me  I  was  on  the  same  track  as  Billy  .  .  . 
perhaps  it  is  the  impression  of  a  few  pet  days  which  I  have  uncon- 
sciously spread  longer,  or  perhaps  the  feeling  grew  upon  me  later  in 
the  run  to  Honolulu.  One  thing  I  am  sure ;  it  was  before  I  had 
ever  seen  an  island  worthy  of  the  name  that  I  must  date  my  loyalty 
to  the  South  Seas.  The  blank  sea  itself  grew  desirable  under  such 
skies;  and  wherever  the  trade-wind  blows,  I  know  no  better  coun- 
try than  a  schooner's  deck."^ 

1  The  Wrecker.    R.  L.  Stevenson  and  Lloyd  Osborne,  New  York,  1893. 


i 


CHAPTEE   XX 


METEOEOLOGICAL  TABLES. 


Table  V.— Annual  Averages  in  the  U.  S.  A. 


Temperature 
Month,  mean 


Ft. 

Adirondacks,  il500 

Asheville,  2250 

Aiken,  I  550 

Thomasville,  ]  o30 

Jupiter  (Fla.),  ,    00 

Key  West,  1    00 

Chattanooga,  j  700 

Denver,  ;  5300 
Colorado  Springs,  6000 


Puehlo, 

Santa  Fe, 

Salt  Lake  City, 

EI  Paso, 

San  Antonio, 

Prescott, 

Tucson, 

Yuma, 

Los  Angeles, 

Santa  Barbara, 

San  Diego, 


St.  Paul, 
Boston, 
New  York, 
Chicago, 
St.  Louis, 
San  Francisco, 


Davos-Piatz, 


,4700 

7000 

4300 

3700 

650 

5300 

2400 

140 

300 

j     00 

i     00 


800    10 

00  27 
00  31 
600 ;  24 
500:  31 
00  i  50 


64°    40° 


5200    20     55 


S-o 


■BS  26 


o  <=^ 


Ip.c. 

69 

65 
82 
75 
71 
50 
50 
49 
48 
54 


58 

68 

35 

51 

44 

42 

49 

46 

52 

72 

51 

73 

52 

73 

36 

74 

40 

72 

43 

73 

41 

73 

46 

70 

49 

75 

31 

77 

2. 44  27.  6  107 
2. 84  46.  0  107 
3.19  45.0  110 
2.88  35.0  117 
3.52,38.0  110 
3.90:24.0  88 


5156 
7997 
6883 
7007 
7011 
6863 


grs.  in.  :  miles,  inch, 

...  |89.0'l292 

3.24  45.0  106  !   

...  !48.o;  ...  ;  

4.86  51.5!  97     4225  |   

7. 21  58.  01  73  6564  I  30.06 

7. 48  40.  0    71  6952  :  30.04 

4.  04  57. 0  102  4116  :  29.28 

2.04  14.41  57  4980  I  24.73 

1.84  14.4'  57  6663     24.03 

2.14  12.0;  53  5438     25.27 

1.79  14.6    48  4681     23.26 

2. 36  18. 9    88  3681     25.64 

3.16    9.0    39  3941     26.21 

5.26  30.6    92  5301     29.33 

2.31  16.0    51  4898  ]  24.74 

3.  25  12. 0    57  3735  !  27.45 

3. 91    3. 0    21  4570     29.76 

4. 42  18.  0    45  3758  I  29.64 

4.20  18.0    73     2872  |   

4. 34  10. 0    69  4105  I  29.92 


29.10 
29.88 
29.85 
29.14 
29.45 
29.87 


Number  of  years  of 
record. 


4 
2 
6 

5  I  7 
19  '  18 
13  i  10 


18  I  10 

12  '  10 

13  10 


2.03  33.6    63      24.86  ,  21      21 


14      11 

14  i  10 


17  I  10 


15 

13 

25 

5 

4 

21 

10 

13 

10 

22 

n 

16 

4 

11 

4 

33 

8 

24 

10 

28 

10 

21 

7 

20 

10 

14 

4 

16 

10 

21 

7 

24 

7 

42 

10 

22 

10 

22 

10 

22 

10 

22 

10 

21 

5 

42 

5 

21 

15 


1  The  elevations  are  given  in  round  numbers  for  convenience  in  memorizing.    They  are 
believed  to  be  within  fifty  feet  of  tlie  actual  measurement. 
-  Adirondacks  cloudy  days  from  record  for  Sarauac  Lake  Weather  Station  for  one  year  (1894). 


452 


MEDICAL  CLIMATOLOGY. 


Table  VI. — Seasonal  Averages,  U.  S.  A. 
Winter  (December,  January,  February). 


Wind. 

Seasonal 

Relative 

Absolute 

Total 

Mean 

tempera- 
ture. 

humidity. 

humidity. 

rainfall. 

monthly 

movement. 

per  cent. 

grains. 

inches. 

miles. 

Adirondacks         .... 

18° 

... 

8.8 

Asheville 

38 

63 

r.'67 

9.3 

Aiken   

46 

63 

2.33 

10.7 

2489 

Thomasville         .... 

50 

63 

2.57 

10.6 

Jupiter  (Fla.)         .... 

64 

82 

5.38 

9.1 

Key  West 

71 

82 

6.56 

5.5 

8029 

Chattanooga         .... 

44 

72 

2.38 

17.4 

4802 

Denver           

30 

54 

1.06 

1.8 

5245 

Colorado  Springs  .... 

29 

50 

0.94 

0.7 

Pueblo 

31 

57 

1.16 

L4 

5027 

Santa  Fe 

30 

52 

L02 

2.3 

4909 

Salt  Lake  City      .... 

31 

56 

L14 

5.5 

3092 

El  Paso 

46 

52 

L84 

L3 

3857       • 

San  Antonio 

54 

69 

3.24 

6.7 

5438 

Prescott 

36 

57 

1.40 

5.0 

4502 

Tucson 

49 

48 

1.89 

3.0 

3567 

Yuma 

56 

47 

2.36 

L6 

4416 

Los  Angeles 

54 

68 

3.19 

11.6 

4031 

Santa  Barbara      .... 

52 

69 

3.02 

1L5 

2588 

San  Diego 

54 

62 

2.91 

5.8 

3842 

St.  Paul 

15 

77 

0.80 

3.2 

4822 

Davos-Platz 

23 

82 

1.21 

6.1 

Albuquerque        .... 

41 

Silver  City 

37 

49 

1.25 

1.0 

Las  Cruces 

43 

43 

1.37 

Eddy 

40 

1.0 

Phcenix 

51 

2.6 

Eedlands 

51 

6.5 

Charleston 

52 

81 

3.'54 

11.0 

Jacksonville 

55 

77 

■      3.52 

10.0 

Nassau  (W.  I.)      .        .       .       . 

70 

83 

6.63 

7.2 

Table  VII. — Seasonal  Averages,  U.S.A. 

Spring  (March,  April,  May). 


Wind. 

Seasonal 

Relative 

Absolute 

Total 

Mean 

tempera- 
ture. 

humidity. 

humidity. 

rainfall. 

monthly 

movement. 

per  cent. 

grains. 

inches. 

miles. 

Adirondacks         .... 

37° 

9.1 

Asheville 

53 

61 

2.76 

11.2 

Aiken     . 

59 

52 

2.89 

13.4 

Thomasville  . 

67 

62 

4.49 

12.9 

Key  West 

76 

71 

6.86 

5.8 

7160 

Chattanooga . 

60 

65 

3.74 

15.2 

4790 

Denver  . 

48 

49 

1.88 

5.8 

5295 

Colorado  Springs 

49 

46 

1.81 

4.5 

Pueblo    . 

51 

45 

1.90 

3.6 

6314 

Santa  Fe 

48 

86 

L37 

2.3 

5378 

Salt  Lake  City 

50 

47 

1.92 

6.1 

4208 

El  Paso  . 

64 

36 

2.36 

0.6 

4853 

San  Antonio . 

68 

66 

4.94 

7.8 

5677 

Prescott . 

51 

44 

1.86 

3.1 

6079 

Tucson   . 

62 

37 

2.  "^7 

L2 

3797 

Yuma     . 

70 

43 

3.43 

0.3 

4830 

Los  Angeles  . 

60 

73 

4.20 

3.8 

3951 

Santa  Barbara 

58 

72 

3.87 

3.9 

3347 

San  Diego 

59 

72 

4.01 

2.3 

4496 

St.  Paul . 

43 

63 

2.0 

7.0 

5873 

Davos-Platz  . 

35 

74 

L74 

6.4 

METEOR  OL  0 GICAL  TABLES. 


453 


Table  VIII.— Seasonal  Averages,  U.  S.  A. 

Summer  (June,  July,  August). 


Seasonal 
tempera- 
ture. 

Relative 

Absolute 

Total 

Wind. 
Mean 

humidity. 

humidity. 

rainfall. 

monthly 

movement. 

per  cent. 

grains. 

inches. 

miles. 

Adirondacks         ....              62° 

10.8 

Bethlehem  (N.  H.) 

65 

65 

4.41 

14.0 

Asheville 

70 

71 

5.67 

13.7 

Aiken     . 

/ 1 

71 

7.08 

13.8 

Thomasville . 

80 

66 

7.22 

16.2 

Key  West 

83 

72 

8.64 

13.4 

5405 

Chattanooga . 

77 

74 

7.38 

12.7 

3278 

Denver  . 

70 

46 

3.67 

4.5 

4806 

Colorado  Springs 

67 

50 

3.62 

7.2 

Pueblo    . 

73 

44 

3.87 

5.0 

5402 

Santa  Fe 

64 

43 

2.82 

6.6 

4628 

Salt  Lake  City 

72 

33 

2.81 

3.5 

4139 

El  Paso  . 

83 

45 

5.40 

4.1 

3742 

San  Antonio  . 

82 

66 

7.68 

8.8 

4698 

Prescott . 

70 

48 

3.83 

6.1 

5167 

Tucson   . 

82 

40 

4.65 

5.4 

3656 

Yuma     . 

89 

43 

6.18 

0.5 

4720 

Los  Angeles  . 

70 

72 

5.75 

0.2 

3616 

Santa  Barbara 

64 

74 

4.86 

0.1 

3130 

San  Diego 

67 

76 

5.52 

0.3 

4320 

St.  Paul . 

69 

71 

5.49 

11.3 

4697 

Davos-Platz 52 

74 

3.29 

n.9 

Table  IX. — Seasonal  Averages,  U.  S.  A. 
Autumn  (September,  October,  November). 


Adirondacks 
Asheville 
Aiken     . 
Thomasville  . 
Key  West 
Chattanooga . 
Denver  . 
Colorado  Springs 
Pueblo    . 
Santa  Fe 
Salt  Lake  City 
El  Paso  . 
San  Antonio  . 
Prescott . 
Tucson   . 
Yuma     . 
Los  Angeles  . 
Santa  Barbara 
San  Diego 
St.  Paul . 


Davos-Platz 


Seasonal 
tempera- 

Relative 

Absolute 

Total 

Wind. 
Mean 

humidity. 

humidity. 

rainfall. 

monthly 

movement. 

per  cent. 

grains. 

inches. 

miles. 

43° 

10.1 

53 

66 

3.0 

8.2 

61 

77 

4.58 

8.4 

66 

67 

4.70 

n.7 

78 

78 

8.02 

15.3 

7213 

61 

73 

4.34 

11.6 

3892 

50 

50 

2.04 

2.3 

4617 

48 

54 

2.05 

2.0 

52 

50 

2.19 

1.7 

4346 

56 

56 

2.81 

3.5 

4101 

52 

49 

2.14 

4.3 

3289 

62 

56 

3.44 

3.0 

3292 

68 

69 

5.16 

8.5 

4930 

53 

49 

2.21 

2.7 

4218 

68 

43 

3.22 

2.4 

3646 

73 

46 

4.04 

0.7 

3646 

64 

68 

4.46 

2.3 

3530 

62 

70 

4.30 

2.5 

2422 

63 

69 

4.38 

1.4 

3760 

45 

68 

2.33 

6.2 

5232 

34 

79 

1.81 

9.2 

454 


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METEOROLOGICAL  TABLES. 


455 


Table  XI. — Night-temperatubes,  U.  S.  A. 


Denver . 

Colorado  Springs 
Pueblo  . 
Santa  Fe 
Salt  Lake  City     . 
Prescott 
Tucson . 
Yuma    . 
El  Paso 
San  Antonio 
Los  Angeles 
San  Diego    .    ,   . 


Boston  . 
New  York 
Chicago 


Winter. 


16° 
17 
15 
20 


Spring.       Summer.       Autumn. 


83° 

32 

34 

35 

37 

36 

47 

54 

50 

58 

48 

51 

40 
40 
36 


55° 
51 

56 
55 
58 
56 
69 
73 
68 
72 
57 
60 

61 
62 
61 


38° 

34 

37 

39 

44 

37 

51 

57 

50 

58 

52 

55 

45 

48 
45 


Year. 


36° 

34 

36 

38 

40 

39 

50 

57 

50 

58 

50 

53 

41 
45 
43 


Note.— An  idea  of  the  average  temperature  during  the  last  half  of  the  night  is  given  by  the 
record  of  the  mean  monthly  minima,  which  record  represents  the  coldest  period  of  the  twenty- 
four  hours,  usually  between  2  and  4  a.m. 

In  the  United  States  an  excellent  standard  for  cool  summer-night  temperature  is  furnished 
by  the  mean  minima  for  July  (for  three  years,  1891-1S93)  of  Eastport  and  San  Francisco,  which 
both  register  51°. 

The  above  table  is  based  on  the  reports  of  the  United  States  Weather  Bureau  for  three  con- 
secutive years  (1891-1893)  for  each  of  the  stations,  except  Colorado  Springs,  two  years  (1893  and 
1894,  except  autumn  one  year,  the  record  for  1894  being  incomplete) ;  Prescott  two  years  (1886 
and  1889) ;  and  Tucson  two  years  (1892  and  1893). 


Table  XII.— Sunrise  and  Sunset  for  the  First  Day  of  January. 


stations. 

Elevation. 

Sunrise. 

Sunset. 

Possible  J 
sunshine. 

SWITZERL.\ND. 

feet. 

hours,  min. 

Maloia 

6000 

9.35  A.M. 

3.45  P.M. 

6         10 

AViesen 

4770 

10.35    " 

3.45    " 

5         10 

Pontresina 

5900 

8.30    •' 

3.10    " 

6         40 

St.  Moritz 

6080 

10.00    " 

3.05    " 

5           5 

Davos-Platz 

5200 

11.03    " 

3.00    '= 

3         57 

Colorado. 

Denver        

5300 

7.30    •' 

4.37     " 

9           7 

Colorado  Springs       .       .       . 

6000 

7.20    " 

4.09    " 

8         49 

456 


MEDICAL  CLIMATOLOGY. 


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458  MEDICAL  CLIMATOLOGY. 

Table  XV. — Comparative  Table  of  Health-resorts.^ 


Average  temperature 

Rainy  days. 

in  winter 

, . , 

. 

Year.       Winter. 
Torquay    ....    154              79 

Madeira    .        .        .    13.5°  R.          62.4°  F. 

Cairo 

13.0                61.25 

Ventnor    . 

152               SO 

Algiers 

11.2                57.2 

Hastings 

152 

Ajaccio 

9.3                -52.9 

Pau   . 

140 

Palermo 

9.1                 52.47 

Pisa  . 

122               62 

Mentone 

90                 52.25 

Madeira 

94               44 

Nice  . 

7.0                47.75 

Venice 

84               22 

Cannes 

7.0                47.75 

Algiers 

83               72 

Pan    . 

6.4                 46.4 

Mentone 

80 

Pisa    . 

6.3                 46.18 

Nice  . 

72               38 

Hyeres 

6.3                 46.18 

Hyferes 

62               17 

Ventnor 

6.1                 45.72 

Montreux 

60               21 

Torquay 

5.6                 44.6 

San  Remo 

56                15 

Venice 

5.5                 44.37 

Cannes 

52 

Meran 

4.3                 41.67 

Meran 

52               13 

Montreux 

3.8                 40.55 

Cairo 

12(?)            9(?) 

Davos  . 

Torquay 

Ventnor 

Pau 

Pisa 

Arco     . 


Absolute 

minima  of 

temperature. 

-24.0°  R. 

—0.22°  F 

-11.0 

+7.25 

-10  0 

9.5 

-10  0 

9.5 

-6.5 

17.38 

—5.0 

20.75 

Average  dififerences  of 
temperature  in  winter. 


Cairo  . 

.    7°to8°R. 

15.75°  to  18°  F. 

Nice    . 

.    4    "  5 

9.0     "  11.25 

Venice 

.    2    "  3 

4.5     "    6.75 

Palermo 

.    1    "  3 

2.25    "     6.75 

1  Taken  from  Dr.  Julius  Braun's  Climatic  Health-resorts. 


INDEX  OF  AUTHORITIES  QUOTED. 


,t  IKEN,  Dr.  J.,  50 
A     Airlong,  Prof.,  82 
Allbutt,  Dr.  Clifford  T.,  33,  50,  54 
Anderson,  Dr.  Winslow,  336,  340,  341, 
342,  343,  346,  349 


BACON,  Dr.  Francis,  208 
Baker,  C.  Alice,  443 
Baldwin,  Dr.  E.  B.,  210 
Barwick,  Sergeant  J.  A.,  337 
Bates,  Dr.  (;.  B.,  339 
Beevor,  Sir  Hugh,  75 
Bell,  Dr.  A.  N.,  222 
Bennett,   Dr.  J.  Henry,  391,  396,  398, 

399,  400,  422 
Bert,  Dr.  Paul,  40 
Bezencent,  Dr.,  417 
Billings,  Dr.  John  S.,  50,  82 
Black,  Hon.  John  A  ,  296 
Black,  Mr.  William,  378 
Blake,  Dr.  J. ,  345 
Blundon,  Mr.  B.  A  ,  201 
Blunt,  Mr.  Thomas  P. ,  81,  83 
Bosworth,  Dr.  Francke,  H.,  149 
Bottini,  Dr.  E..  132 
Bouveret,  Dr.  L.,  149 
Bowditch,  Dr.  V.  Y.,  84.  88,  133,  137, 

138,  140,  195,  209 
Bowers,  Dr  Stephen,  93 
Braun,  Dr.  Julius,  380,  406,  409,  412 
Brehmer,  Dr.  G.,  410 
Brown-Sequard,  Dr.,  80 
Bruen,  Dr.  E   T.,  137 
Bryce,  Dr.  P.  H.,  187 
Buchanan,  Dr.  G.  S  ,  84,  88 
Buchner,  Dr.  E.  C,  82 


nASSE,  Dr.  J.,  150 

yj     Chandler,  C.  F.,  Ph.D.,  234,  267 

Charteris,  Dr.  M.,  381,  388,  403 

Chrystie,  Dr.  Walter,  150 

Cline,  Dr.  I.  N  ,  234 

Conway,  Sir  Martin,  45 

Copland,  Dr.  J.,  48,  50,  80 

Cormack,  Dr.  Charles,  397 

Cunningham,  Mr   A.  A.,  263 

Curtin,  Dr.  R.  G.,  137 

Curtis,  Mr.  W.  E  ,  369 


DALE,  Lieut.,  92 
Darwin,  Mr.  Charles,  49 
Davidson,  Dr  ,  18 

Davis,  Prof.  W.  M.,  19,  27,  28,  33,  374 
Denison,  Dr.  Charles,  133,  156,  188,  241, 

244,  270,  283 
D'Espine,  Dr.  C-,  150 
Dettweiler,  Dr.,  410 
De  Wit,  Dr.  P.  C,  426 
Donaldson,  Dr.  F.,  137 
Downes,  Dr.  A,  81,  83 
Drysdale,  Mr.  William,  435,  438 
Duclaux,  Dr  ,  82 


EAGER,  Dr.  J.  H.,  228 
Egger,  Dr.  J.  N.,  414 
Eskridge,  Dr.  J.  T.,  61 


FABER,  Dr.  C,  132 
JL      Fayrer,  Sir  Joseph,  330 
Field,  Kate,  320 
Fisk,  Dr.  Samuel,  131 
Flint,  Dr.  Austin,  126 
Fox,  Dr.  Wilson,  126 
Frankland,  Dr.  E.,  386 
Frost,  Mr.  Max,  274 


pARDINER,  Dr.  C.  F.,  116 

U     Garrod,  Sir  A.,  180 

Geddings,  Dr.  W.  H.,  132,  206,  224 

Geiseler,  Prof.,  82 

Glassford,  Capt.  W.  A.,  287,  288,  291, 

294,  296,  299 
Gleitsmann,  Dr.  J.  W.,  221 
Goldschmidt,  Prof.,  132 
Gooch,  Mrs.  F.  C,  336  , 
Greely,  Gen.  W.  H.,  66,  67,  237,  291, 

296,  322, 335,  338 


HAIG,  Dr.  Alex.,  179 
Haines,  Dr.  W.  S  ,  278 
Hall,  Maxwell,  M.A.,  440 
Hall,  W.  H.,  C.E.,  306 
Hall,  Mr.  W.  W.,  408 
Hamilton,  Mr.  P  ,  295 
Hammond,  Dr.  W.  A.,  276 


460 


INDEX  OF  AUTHORITIES  QUOTED. 


Hanks,  Prof.,  93 

Hare,  Dr.  H  A  ,  86 

Harrington,  Prof.  M.  W.,  62,  63,  64,  221, 

223,  273,  280,  292,  306 
Hart,  Dr.  Ernest,  442 
Hassall,  Dr.  A.  H.,  399 
Hassaurek,  Mr.  F.,  370 
Hector,  Dr.,  433 
Hellwig,  Prof.  C,  120 
Heuss,  Mr.  F.,  179 
Hilgard,  Prof.  E.  W.,  330 
Hirsch,  Dr.  A.,  18,80,86,87 
Hittell,  Dr.  J.  S.,  297,  300,  344 
Holden,  Mr.  C  F.,  352 
Humboldt,  Prof.,  355 
Hunter,  Dr.,  87 


[NGALLS,  Dr.  E.  F.,  137 


TACOBI,  Dr.  A.,  150 
«J     James,  Dr.  Bushrod  W.,  369 
Johnson,  Dr.  H.  A.,  132,  133 
Jourdanet,  Prof.  D.,  18 
Judd.  Dr.  L.  D.,  219 


KEATING,  Dr.  J.  M.,  225,  227 
Kelley,  Mr.  W.  D.,  369 
Knight,  Dr.  F.  I.,  137,  143,  160 
Koch,  Dr.  K.,  78,  82 
Koeppe,  Dr.,  412 
Kriimmel,  Dr.  Otto,  374 


T  AMONT,  Prof.,  38 

1j     Lane,  Mr  G.  W.,  285 

Langenbeck,  Dr.  Carl,  253 

LaEoux,  Dr.  C.  L.,  230 

Levy,  Dr.  Robert,  146 

Lindley,  Dr.  W.,  92,  94,  303,  316,  317, 

332,  333 
Loetscher,  Dr.  J.,  417 
Loew,  Prof.  O.,  259,  265 
Lombard,  Dr.  H.  C,  18,  80 
Longstreth,  Dr.  Morris,  195 
Loomis,  Dr.  A.  L.,  211 
Lownes,  Mr.,  141 
Lummis,  Mr.  C.  F.,  276,  372 
Lund,  Dr.,  132  ' 
Lyons,  Prof.  C.  T.,  447 


McKAY,  Dr.  A.  F.,  281 
McKibbin,  Dr.  B.  M.,  448 
MacCarthy,  Prof.  F.  J.,  351 
Maclaren,  Mr.  Charles,  185 
Madden,  Dr.  T.  M.,  398 
Martin,  Sir  Ranald,  432 
MiUer,  Dr.  William,  234 


Milroy.Dr.  G  ,  84 
Minck,  Dr.  G.  X.,  82 
Mittemaier,  Dr.,  132 
Miiller,  Prof.,  120 
Mullins,  Dr.  G.  L.,  425 
:Musser,  Dr.  J.  H.,  137 


ABER,  Mr.  F.  A.,  356 
U     Oertel,  Dr.  M.  J.,  113 
Ord,  Dr.  William  M.,  58 
Osborne,  Mr.  Llovd,  450 
Osier,  Dr.  W.,  79" 
Oswald,  Dr.  Felix  L.,  359 
Otter,  Mr.  R.  H.,420,  429 


PARKER,  Mr.  John  D.,  319 
Peckham,  Dr.,  82 
Peirce,  Mr.  E.  M.,  328 
Peltier,  Prof. ,  38 
Pepper,  Dr.  William,  84,  88 
Perez,  Dr.  G.  Y.,  445 
Peterson,  Dr.  F.,  421 
Petin,  Dr.,  284 
Pickering,  Prof.  G.,  372 
Piatt,  Dr.  I.  H.,  216 
Piatt,  Dr.  Walter  B.,  418 
Precht,  Prof.,  284 


RALPH,  Mr.  Julian,  249 
Reed,  Dr.  Boardman,  137,  201 
Remondino,  Dr.  P.  C,  311 
Renton,  Dr.  J. ,  132 
Richards,  Dr.  Huntington,  202 
Roberts,  Dr.  W.  P.,  251,  262 
Rohden,  Dr.  L.,  18,  399 
Rotch,  Dr.  A.  Lawrence,  372 
Roux,  Prof.,  83 
Ruedi,  Dr.  Carl,  133,  242,  246,  415 


Q ANDERSON,  Dr.  Burdon,  42 
O     Sandwith,  Dr.  F.  M.,  133,  420 
Saussure,  Prof.,  37 
Sawyer,  Dr.  W.  B.,  19,  20,  327 
Schiibler,  Prof.,  37 
Scrivener,  Mr.  J,  H.,  373 
Shattuck,  Dr.  F.  H.,  137 
Smith,  Dr.  Andrew  H.,  40,  95 
Smith,  Dr.  Archibald,  114,  159,  373 
Smith,  Dr.  F.  Fremont,  204 
Sparks,  Dr.,  132 
Spengler,  Dr.,  133 
Squier,  Dr.  E.  G.,  372 
Stark,  Mr.  J.  H.,  435,  438 
Sternberg,  Dr.  G.  M.,  83 
Stevenson,  Mr.  Robert  Louis,  449 
Stoddard,  Dr.  T.  A.,  264 
!  Stokes,  Dr.  W. ,  80 
Svmonds,  Lieut. ,  92 


INDEX  OF  AUTHORITIES  QUOTED. 


461 


rPABAEIE,  Dr.  L.  E.,  94 
1      Taylor,  Mr.  Benjamin,  231 
Thompson,  Dr.  St.  Clair,  407 
Thompson,  Dr.  Symes,  424 
Thompson,  Dr.  W.  Gilman,  40 
Toner,  Dr.  J.  M.,  222 
Treves,  Dr.  Frederick,  150 
Trudeau,  Dr.  E.  L.,  78,  80,  82, 133,  138, 

139,  140,  211 
Turner,  Mr.  E.  T.,  213 


T7AIL,  Mr.  HughD.,  339 
V      Van  Someren,  Dr.  G.  A.,  430,  431 
Vincent,  Mr.  Frank,  369,  372 
Virchow,  Dr  R.,  149 
Von  Euck,  Dr.  Karl,  133,  139,  221 
Von  Vivenot,  Prof.,  18,  41 
Von  Ziemssen,  Prof.,  38 


WAGNER,  Dr.  Clinton,  146 
Wall,  Dr.  J.  P.,  204,  226 
Waller,  Dr  ,  260 
Walshe,  Dr.  W.  H.,  126 
Ward,  Hon.  C.  H.,  440 


Waring,  Prof.  W.  E.,  282 
Warner,  Mr.  C.  Dudley,  337 
Warner,  Dr.  Emerson,  442 
Waters,  Mr.  A.  W.,  252,  415,  418 
Weber,  Dr.  Hermann,  18,  41,  55,  80,  89, 

132,  138,  140,  100,  380,  401    ' 
Wendt,  Dr.  G.  C,  34 
Wesselovski,  Prof.,  375 
Whymper,  Mr.  E.,  44,  45,  46,  47,  371 
Widney,  Dr.  .J.  P.,  303,  307,  309,   310, 

311,  350,  351 
Williams,  Dr.  C.  T.  B.,  18,  126 
Williams,  Dr.  C.  T.,  18,  41, 126,'129,  132, 

245,  372,  395,  396,  415,  423    ' 
Williams,  Dr,  Harold,  198 
Wilson,  Dr.  J.  C  ,  227,  229 
Wise,  Dr.  Tucker,  418 
Woiekof,  Prof.  A.,  80,  369 
Wolf;  Dr.,  412   m':i 
Woodhead,  Dr.  G.  Symes,  75 


VANDELL,  Dr.  W.  M.,  276 
1      Yeo,  Dr.  I.  B  ,  18,  385, 387, 391,  392, 

393,  402,  405,  407,  413,  416 
Youatt,  Dr.  VV.,  49 


INDEX  TO  TABLES. 


Table  I. 

Table  II. 

Table  III. 

Table  IV. 

Table  V. 

Table  VI. 

Table  VII. 

Table  VIII, 

Table  IX. 

Table  X. 

Table  XI. 

Table  XII. 

Table  XIII. 

Table  XIV. 

Table  XV. 

Atlantic  Coast  Climates  in  the  United  States,  194 

Colorado  Springs.     Mean  for  Two  Years  (189-3  and  1894),  258 

Davos-Platz,  415 

Kingston,  Jamaica,  440 

Annual  Average-s  in  the  U.  S.  A.,  451 

Seasonal  Averages  (Winter),  452 

Seasonal  Averages  (Spring),  452 

Seasonal  Averages  (Summer),  453 

Seasonal  Averages  (Autumn),  453 

Winter  Weather,  U.  S.  A.,  Supplementary  Table,  454 

Night-temperature,  U.  S.  A.,  455 

Sunrise  and  Sunset  for  the  First  Day  of  January,  455 

Mexican  Cities,  Annual  Averages  (from  Records  of  the  Mexican 

Government),  456 
Comparative  Table  of  Health-resorts,  457 
Comparative  Table  of  Health-resorts,  458 


INDEX. 


A  ACHEN,  409 
A     Aci  Keale,  402 
Adirondack  Lodge,  212 
Adirondacks,  209 
Africa,  resorts  of,  425 
Aguas  Calientes,  350,  362 
Aiken,  223 
Air,  composition  of,  24 

compressed,  uses  of,  41,  42,  95 
evaporative  power  of,  31 
humidity  of,  and  phthisis,  84 
mountain,   use   of.      (<S'ee    Elevated 

Climates.) 
purity  of,  80 

sea,  use  of,  in  kidney-diseases,  174 
in  liver-diseases,  175 
in  nervous  disorders,  162 
in  neurasthenia,  167 
in  phthisis,  136 
in  scrofulosis,  150 
Aix-les-Bains,  393 

-la-Chapelle,  409 
Ajaccio,  400 
Albuquerque,  280 
Alcohol,  163 
Algeria,  resorts  of,  422 
Algiers,  422 
Aliwal  North,  425 
Altamonte,  229 
Ampersand,  211 
Ansemia,  effects  of  altitude  upon,  111,113 

use  of  compressed  air  in,  97 
Andermatt,  417 

Anderson  Mineral  Springs,  347 
Aneurism,  effects  of  altitude  upon,  159, 

160 
Antelope  Valley,  334 
Apoplexy,  165 
Arcachon,  390 
Ardrossan,  378 
Arequipa,  372 
Argentine  Kepublic,  373 
Arizona,  resorts  of,  287-301 
Arkansas,  resorts  of,  231 
Aroostook  Country,  205 
Arosa,  414 

Arrowhead  Hot  Springs,  330 
Asburv  Park,  200 
Asheville,  221 
Asia,  427 


Asia,  therapeutically  useful  districts  of, 

427 
Asthma,  bronchial,  154 

eflect  of  compressed  air  upon,  97 

nasal  (hay-fever),  156 

nature  and  causes  of,  153 

use  of  depressed  climates  in,  93,  94 
Athletic  feats,  46,  47,  106,  112 
Atlantic  City,  200 

coast  resorts,  194-203 

climatic  characteristics   of, 
194 
Atlas  Peak,  344 
Auckland,  433 
Audierne,  390 
Augusta,  224 
Ausable  Lakes,  212 
Australia,  resorts  of,  430 
Australasia,  428 
Austria,  coast  resorts  of,  404 

inland  resorts  of,  404-406 
Avelon,  351 
Azores,  the,  441 
Azule  Springs,  348 

BAASSEN,  408 
Baden,  405 

-Baden,  412 
Bagneresde-Luchon,  394 
Bahama  Islands,  434 
Balloon  ascents,  43 
Bandarem,  377 
Banff,  188 
Banning,  332 
Barbados,  climate  of,  441 
Bareges,  394 
Barnegat,  200 

Barometric  pressure.    {See  also  Depressed 
Climates     and     Oxygen-ten- 
sion ) 
decreased,  42 

balloon  ascents,  43 
blood-changes  due   to,  43, 

99, 109 
effects  of,  on  heart,  43,  45, 

46  _ 

mountain-climbing,  44 

-sickness,  43 
oxygen -tension,  42 
increased,  40 


464 


INDEX. 


Barometric  pressure,  increased,  effects  of 
sudden  change  in,  40 
experiments  in,  40 
physiologic  effects  of,  40 
Bartfeld,  408 
Bath,  386 
Baths,  compressed  air,  41,  42,  95 

sea-,  58,  150 
Beach  Haven,  200 
Beaufort  West,  425 
Beaumont,  331 
Bechuanaland,  426 
Belgium,  climate  of,  388 

resorts  of,  388 
Bermuda  Islands,  resorts  of,  434 
Bethlehem,  206 
Beulah,  264 
Biarritz,  390 
Biskra,  423 
Blankenberghe,  388 
Block  Island,  199 
BloemfonteiU;  426 

Blood,  changes  in,  due  to  altitude,  43,  99, 
109 

germicidal  power  of,  113,  114 
Blue  Mountain  Lake,  212 
Boerne,  234 
Bogota,  369 
Bordighera,  399 
Boulder,  249 
Boulogne-sur-Mer,  389 
Bournemouth,  382 
Bowel-diseases,  178 

tuberculous,  179 
Bray,  377 
Bregenz,  406 
Bridge  of  Allan,  379 
Bridgetown,  441 
Bridlington,  385 
Brigantine  Beach,  200 
Brighton,  382 
British  Isles,  the,  376,  377 
Broadmoor,  261 
Broadstairs,  384 
Bronchitis,  change  of  climate  for,  153 

chronic,   effects   of    compressed   air 
upon,  98 
Burghersdorp,  425 
Burtscheid,  409 
Buxton,  385 
Byron  Spring,  347 

r<AIRO,  420 

\J     Caisson  disease,  99 

Calabasas,  301 

Caledonia  Springs,  190 

Calgary,  189 

California,  resorts  of,  316-353 

Seltzer  Springs,  347 
Calistoga  Springs,  347 
Camden,  223 
Canada,  climate  of,  187 

resorts  of,  188-191 


Canary  Islands,  445 
Cannes,  398 
Cafion  City,  264 
Cape  Ann,  197 

Cod,  197 

May,  202 

St.  George,  431 

Town,  425 
Carlsbad,  404 

Carnelian  Mineral  Springs,  350 
Cascade,  261 

Castellamare  di  Stabia,  403 
Castle  Creek  Hot  Springs,  301 
Catania,  402 
Catarrh,  as  a  cause  of  phthisis,  117 

nasal  and  pharyngeal,  157 
Cauterets,  394 
Chalk  Creek  Springs,  271 
Channel  Islands,  climate  of,  388 

resorts  of,  350 
Chattanooga,  230 
Chest  expansion ,  effects  of  altitude  upon, 

112 
Cheyenne  Valley,  261 
Chihuahua,  360 
Chorea,  164 
Christchurch,  433 
Clear  Lake,  345 
Climate,  classification  of,  57 

coast,  59,  130,  132 

definition  of,  21 

depressed,  42,  60,  91,  93,  94 

desert,  130,  133,  165,  175.    (<See  also 
Depressed  Climates.) 

drv  and  moist,  33 

elevated,  60,  99,  130,  133 

ethnologic  effects  of,  48 

influence  of,  upon  germ  life,  53 

inland,  59,  130,  132 

island,  59,  130,  132 

moderately  dry,  cold,  60,  91 
warm,  60,  91 
moist,  cool,  60,  91 
warm,  59,  60,  91 

ocean,  57 

physics  of,  23 

physiologic  effects  of,  39 

summer  and  winter,  62 

temperate,  51 
Climatology,  medical,  21 
Clouds,  31 
Cobb  Valley,  346 
Cold,  general  causes  of,  36 

local  causes  of,  37 

physiologic  effects  of,  36,  37,  39 
Colesberg,  425 
Colorado,  resorts  of,  261,  271 

Springs,  253 
Concarneau,  390 
Conduction,  36 
Connecticut  Shore,  1 99 
Constipation,  179 
Convection,  27 


INDEX. 


465 


Cornwall,  379 
Coronado  Beach,  320 

Springs,  320 
Corral  de  Luz  Hot  Springs,  349 
Corsica,  400 
Cottage  City,  197 
Cradock,  426 
Cresson  Springs,  218 
Crieff,  379 
Crittenden,  301 
Croupous  pneumonia,  151 
Currents,  atmospheric.     {See  Winds.) 

ocean,  58,  185,  186,  194,  304,  319, 
336,  350,  874,  380 
Currituck  Sound,  203 

DAGGETT,  334 
Dagshai,  427 
Dalhousie,  191 
Darjiling,  427 
Davos,  414 
Death-rates  from  phthisis,  102 

tables  of,  103-105 
in  various  germ-diseases,  54 
Deer  Park,  220 
Delaware  Water  Gap,  218 
Deming,  280 
Denver,  249 
Depressed  climates,  42,  60 

influence  of,  upon   asthma,  93, 
94 
upon  phthisis,  91,  93,  94 
Desert  climates.     ((See  Climate. ) 
Dew-point.  34 
Diabetes,  174 
Diarrhoea,  178 
Dieppe,  389 
Dinard,  390 
Donaghadee,  177 
Doolan  Vichy  Springs,  346 
Douarnenez,  390 
Dover,  383 
Droitwich,  386 
Dublin,  207 
Dundrum,  177 
Dunmore  Town,  438 
Durango,  361 
Dust,  26 
Dyspepsia,  177 

EAGLE'S  MERE,  219 
Earth  in  relation  to  climate,  25 
Eastbourne,  382 
East  Gloucester,  197 
Eastport,  195 
Echo  Mountain,  326 
Eden,  431 
Edgartown,  198 
Egypt,  resorts  of,  420 
Elberon,  199 
Electricity,  37 
Eleuthera,  437 


Elevated  climates,  active  hypersemia  of 
the  brain  in,  163 
blood-changes  in,  43,  99,  109 
effects  of,  in  aneurisms,  114 
on  healthy  kidneys,  173 
on  kidney-diseases,  170 
on  liver-diseases,  175 
in  nervous  disorders,  162 
in  scrofulosis,  150 
influence   of,    upon    prevalence 

of  phthisis,  99 
inherent  nervous  irritability  in, 

164 
insanity  in,  164 
insomnia  in,  163 
neurasthenia  in,  167 
physiologic     effects    of,     upon 

phthisis,  108 
sanitary  effects  of,  106,  115 
therapeutic    effects    of,      upon 
phthisis,  113 
El  Paso,  231 
Elsinore  Springs,  349 
Emphysema,  use  of  compressed  air  in,  98 
Empyema,  153 
England,  climate  of,  379 
coast  resorts  of,  379,  385 
inland  resorts  of,  385 
Epilepsy,  164 
Estes  Park,  245 
Ethnological  considerations,  48 
Etretat,  389 
Eureka  Springs,  231 
Europe,  extent  of,  374,  375 
Eustis,  229 

Evaporation,  its  general   effects,  31,  35, 
115 

T7ALKENSTEIN,  410 
r     Falmouth,  381 
Fayal,  442 
Felixstowe,  384 
Filey,  385 

Florida,  resorts  of,  228,  229 
Fogs,  influence  of,  upon  phthisis,  195 
Folkestone.  383 
Folsom  Hot  Springs,  286 
Food,   effects    of    increased    barometric 
pressure  on  consumption  of,  40 

relation  of  climate  to,  50 
Fort  Apache,  299 

Bavard,  282 

Bliss,  232 

Defiance,  299 

Grant,  299 

Huachuca,  300 

Verde,  300 
France,  coast  resorts  of,  389-391 

inland  resorts  of,  391-394 
Franconia  Village,  208 
Fulton  Artesian  Wells,  349 
Fulton  Chain  region,  212 
Funchal,  444 


30 


466 


INDEX. 


GALL-STONES,  177 
Galveston,  235 

Genoa,  399 

Geographical  distribution  of  disease,  53. 
{See  also  Germs.) 
modification  of,  by  season 
and  weather,  55 

Georgia,  resorts  of,  224 

Germany,  resorts  of,  409,  413 

Germs,  26,  53 

altitude  as  affecting,  114,  115,  116 
contagion  from,  53 
influence  of  climate  upon,  53 
innocence  and  virulence  of,  54,  55 
prevalence  of,  53 
sunlight  and  heat  as  affecting,  81 
tubercle-bacillus.       (See     Tubercle- 
bacillus.  ) 

Geysers,  347 

Gijon,  395 

Gilmanton,  207 

Gizeh,  421 

Glengarrift",  377 

Glen  Summit,  218 

Glenwood  Springs,  266 

Gloucester,  197 

Gorbersdorf,  410 

Gout,  179,  180 

Governor's  Harbor,  438 

Grand  Junction,  268 

Granville,  390 

Gravenhurst,  190 

Great  Lakes,  climate  of,  191 

Green  ^Mountain  Falls,  261 

Grindelwald,  417 

Guadalajara,  357 

Guadalupe,  362 

Guanajuato,  3fi3 

Gulf  coast,  resorts  of,  229 

HAMILTON,  434 
Hampton  Beach,  196 

Harbin  Hot  Springs,  347 

Harkanyi,  408 

Harrogate,  386 

Hartzell's  Hot  Sulphur  Springs,  271 

Hastings,  383 

Hawaii,  448 

Hawaiian  Islands,  446 

Hay  fever,  156.    (See  Asthma  ) 

Healing  Spring,  220 

Heart,  diseases  of  the  great  vessels  and, 
158 
effects  of  compressed  air  upon,  41 ,  96 
physiologic  effects  of  decreased  baro- 
metric pressure  upon,  43,  112 

Heat,  36,  37 

physiologic  effects  of,  39 

Helensburgh,  378 

Heligoland,  387 

Helouan,  421 

Hemorrhage,  effects  of  altitude  upon,  114 

Herculesbad,  408 


Heredity,  80,  145 
Hesperia,  333 

High  altitude,  effects  of,  upon  sanitation, 
115 
general   therapeutic   effects   of, 
113 
Himalavas,  resorts  of,  427 
Hobart  Town,  432 
Holland,  climate  of,  387 

coast  resorts  of,  387 
Hollywood,  199 
Honolulu,  446 
Hooker's  Hot  Springs,  301 
Hot  Springs,  220,  231 

Sulphur  Springs,  271 
Howell  Mountain,  345 
Howth,  177 
Humidity,  absolute,  33 

physiologic  effects  of,  39 

and  altitude,  114 

and  sensible  temperature,  32 

relative,  33 

temperature  and,  34 

of  air,  84 

of  soil,  84 
Hungary,  resorts  of,  407,  408 
Hyeres,  397 
Hysteria,  164 

IDAHO  SPRINGS,  270 
1     Ilfracombe,  381 
Ilkley,  385 
Indio,  332 

Individual,  the,  in  climatotherapy,  118 
conduct  of,  123 
temperament  of,  120 
Insanity,  164 
Insomnia,  163 
Irapuato,  363 
Ireland,  climate  of,  376 

resorts  of,  376 
Ischia,  403 
Ischl,  406 

Island  of  Tenerifte,  445 
Isles  of  Shoals,  196 
Italy,  coast  resorts  of,  402 

inland  resorts  of,  403 

JACKSONVILLE,  228 
J     Jaffrey,  208 
Jalapa,  366 

Jamaica,  climate  of,  438 
Jauja,  373 
Jefferson,  207 
.Jemez  Hot  Springs,  286 
Johannesburg,  426 
Johannisberg,  410 
Jordan  Alum  Springs,  220 
Julian,  322 

KA]MLOOPS,  188 
Kane,  218 
Kassauli,  427 


INDEX. 


467 


Tvatama,  198 

Keene  Valley,  212 

Kennebunkport,  196 

Kidney-diseases,  96,  168 

climatic  treatment  of,  170 
effects  of  compressed  air  upon,  96 
hepatic  complications  in,  174 
influence  of  climatic  factors  in,  169 
lardaceous,  172 
prevalence  of,  168 

Kilkee,  377 

Kilrush,  377 

Kimberly,  426 

Kingston,  439 

Kingstown,  377 

Kissingen,  413 

Kreuznach,  412 

T  A  BOURBOULE,  393 
-L     Ladybrand,  426 
Lake  Champlain,  214 
George,  214 
Placid,  212 
Tahoe,  346 
Worth,  229 
Lakes,  influence  of,  upon  climate,  30 
Lakewood,  217 
Laryngitis,  chronic,  158 

tubercular,  146 
Las  Cruces,  283 
Vegas,  278 

Hot  Springs,  278 
Laubbach,  410 
Le  Croisic,  390 
Leesburg,  229 
Lemoenfontein,  425 
Leon,  363 
Leysin,  417 
Lisbon,  395 
Lisdunvarna,  377 
Liver,  diseases  of,  175 

climatic  treatment  of,^175 
functional,  175 
mineral  waters  in,  177 
organic,  175 
Llandudno,  380 
Long  Branch,  199 
Los  Angeles,  324 

Banos  Chicos,  362 
Pinellas,  229 
Lucca,  403 
Luhatschowitz,  405 
Luxor,  421 

MADEIRA  ISLANDS,  443 
Maine,  resorts  of,  204,  205 
Malaga,  395 
Maloja,  418 
Malta,  401 
Malvern,  386 
Mandeville,  439 
Mauitou,  259 
Park,  261 


Maple  wood,  206 
Margate,  384 
Marienbad,  405 
Martha's  Vineyard,  197 
Maryland,  resorts  of,  220 
Massachusetts,  resorts  of,  208,  209 
Matlock,  386 
Mauch  Chunk,  218 
Mediterranean  Islands,  400 
Mehadia,  408 
Melbourne,  430 
Meningitis,  163 
Mentone,  398 
Meran,  406 
Mesilla  Valley,  282 
Meteorology,  21 

comparative  tables  of,  451 
Mexico,  City  of,  355 

resorts  of,  355-366 
Migraine,  164 
Mirror  Lake,  212 
Mists,  31 
Mobility  of  atmosphere,   89.     (^e   also 

Winds. ) 
Mofiatt,  379 
Moneague,  439 
Monmouth  Beach,  199 
Mont  Dore-les-Bains,  392 
Monterey,  344,  359 
Montreux,  414 
Moosehead  Lake,  205 
Morelia,  365 
Morocco,  resorts  of,  423 
Mount  Desert,  195,  196 

Dora,  229 

Harvard,  326 

Lowe,  326 

Pocono,  219 

Wachusett,  209 
Mountain-climbing,  44 

-sickness,  43 
Mountains,  influence  of,  upon  climate,  25 
Murree,  427 
Murren,  417 

YTAIRN,  378 

\S     Nantucket,  198 

Napa  Soda  Springs,  345,  347 

Valley,  344 
Naples,  403 
Narragansett  Pier,  199 
Nassau,  435 
Nauheim,  411 
Nephritis,  acute,  171,  172,  173 

chronic,  172,  173 

scarlatinal,  173 
Nervi,  400 

Nervous  disorders,  climatic  change  in, 
162 
effects  of  altitude  on,  115 
use  of  compressed  air  in,  115 
Neuenahr,  410 
Neuralgia,  164 


468 


INDEX. 


'Neurasthenia,  165 

Newcastle,  177 

New  Castle,  196,  439,  431 

Hampshire,'resorts  of,  206-208 

Jersey  coast,  199 

resorts  of,  216,  217 

Mexico,  resorts  of,  273 

Providence,  435 

York,  resorts  of,  209-215 

Zealand,  resorts  of,  433 
Newport,  198 
Nice,  398 
Nilgiri  Hills,  428 
Nogales,  301 
Nordernev,  387 
Nordhoff,"  334 
Norfolk,  203 

North    America,    general     climatology, 
185 

Berwick,  378 

Carolina,  resorts  of,  221,  222 

Sea  Islands,  387 
Norway,  387 
NyneeTal,  427 

AAKI,  447 

U     Oban,  378 

Occupation,  as  affecting  phthisis,  88,  103 

Ocean  Grove,  200 

Ojai  Valley,  334 

Ojo  Caliente  Springs,  286 

Old  Camp  Crittenden,  301 

Orchard  Beach,  196 

Point  Comfort,  203 

Sweet  Springs,  220 
Oporto,  395 
Oracle,  297 
Oran,  423 
Orange,  431 
Oregon,  resorts  of,  354 
Orizaba,  366 
Orlando,  228 
Orotava,  445 
Ostend,  388 

Oxygen,  109.     {See  also  Balloon  Ascents 
and  Mountain-sickness. ) 

-tension,  effects  of  decreased  barome- 
tric pressure   upon,  42, 
108 
of     increased     barometric 
pressure  upon,  40 
Ozone,  26 

PACHUCA,  364 
Pagosa  Springs,  271 
Paimpol,  390 
Palatka,  228 
Palermo,  402 
Palm  Beach,  229 
Springs,  332 
Panticosa,  395 
Paraiso  Hot  Springs,  348 
Pasadena,  325 


Paso  Eobles,  340 

Pass  Christian,  230 

Piitzcuaro,  365 

Pau,  394 

Paul  Smith's,  210 

Pecos  Valley,  279,  284 

Pegli,  400 

Pennsylvania,  resorts  of.  218,  219 

Perspiration,  39,  176 

Peterboro,  208 

Petersham,  209 

Phrenix,  295 

Phthisis,  catarrhal,  117 

causes  of,  79 

chart  showing  comparative  results  of 
climatic  change  in,  136 

death-rates  from,  102 

definition  and  nature  of,  73 

early  diagnosis  in,  142 

forms  of,  as  influenced  bv  climate, 
117 

indications  and  contraindications  in 
climatic  treatment  of,  143 

influence  of  sea-air  upon,  136 

personal  equation  in,  118 

physiologic  effects  of  altitude  upon, 
i08 

pneumonic,  117 

prevalence  of,  80 

rarity  of,  in  elevated  climates,  100 

sanitarium-treatment  in,  133,  138 

stage  of,  and  results,  141 

statistics  concerning  climatic  change 
in,  128 

syphilitic,  137 

therapeutic   effects   of    altitude 
upon,  113 

treatment  of,  by  change  of  climate 
126 

tuberculin-treatment  in,  139 

tuberculous,  117 

use  of  compressed  air  in,  96,  98 
Phj'siological  considerations,  39 
Pine  belt,  the,  216 

Mountain,  336 
Pinehurst,  222 
Plains,  25 
Pleurisy,  153 
Plymouth,  197 
Pneumonia,  catarrhal,  152 

croupous,  151 

effects  of  cool,  dry  air  in,  118 
Poland  Springs,  205 
Polar  regions,  the,  51,  90 
Poncha  Springs,  271 
Pontresina,  418 
Population,  density  of,  80,  88 
Pornic,  390 
Portland,  196,  354 
Port  Maquaire,  431 

Stewart,  177 
Portrush,  177 
Portsmouth,  196 


INDEX. 


469 


Portugal,  resorts  of,  395 

Prescott,  293 

Pretoria,  426 

Princeton,  208 

Puebla,  365 

Pueblo,  262 

Puget  Sound  district,  354 

Pulse,   effects    of   decreased   barometric 

pressure  upon,  43,  45,  46 
of  increased  barometric  pressure 

upon,  40 
Pyrmont,  409 

QUEENSTOWN,  377 
Queretaro,  364 
Quito,  370 

RADIATION,  36.     (^e  Sun. ) 
Rainfall,  30 

of  the  Southwest,  237 
Bamsgate,  384 
Rangeley  Lakes,  204 
Raquette  Lake,  212 
Redlands,  327 
Reiboldsgriin,  412 
Respiration,  absolute  humidity  and,  39 

effects  of  decreased  barometric  pres- 
sure upon,  43,  113 
of  increased  barometric  pressure 
upon,  40 
Rheumatism,  179-181 

articular,  180, 181 

muscular,  180,  181 

nervous,  180,  181 
Rialto,  329 

Richfield  Springs,  215 
Rindge,  208 
Rippoldsau,  412 
Riverside,  326 
Riviera,  the,  climate  of,  396 

French,  resorts  of,  397,  398 

Italian,  resorts  of,  399,  400 
Rome,  403 
Roscoff,  390 
Rosstrevor,  177 
Rothesay,  378 
Royat-les-Bains,  392 
Royan,  390 

Russia,  climate  of,  408 
Rye  Beach,  196 

QT.  AGATHE,  190 
0     Andrews,  378 

Augustine,  203 

Georges,  434 

Jean  de  Luz,  391 

Lawi-ence  River  resorts,  189 

Leon  Springs,  190 

Leonards,  383 

Malo,  390 

Michael's,  441 

Moritz,  418 
Saltillo,  360 


Salt  Lake  City,  271 
Samaden,  417 
San  Antonio,  232 

Diego,  316 

Luis  Potosi,  362 

Eemo,  399 

Sebastian,  395 
Sanitation,  effects  of  altitude  upon,  106, 

115 
Sanitariums,  133,  138 
Santa  Barbara,  336 

Hot  Springs,  339 

Catalina,  351 

Cruz,  353 

Fe,  279 

Eosa,  353 
Sao  Miguel,  442 
Saranac  Lake  Village,  211 
Saratoga  Springs,  215 
Scarborough,  385 

Beach,  196 
Scheviningen,  388 
Schwalbach,  411 
Scotland,  441 

climate  of,  377 

resorts  of,  378,  379 
Scrofulosis,  149 

sea-bathing  in,  150 

and  mountain  air  in,  150 
Sea  Girt,  200 

Seas,  influence  of,  upon  climate,  50 
Seattle,  354 
Seelisberg,  413 
Seltzer  Springs,  270 
Sespe  Valley,  336 
Seven  Oaks,  330 
Seville,  395 
Sharon,  209 

Springs,  215 
Siasconset,  198 
Sicily,  resorts  of,  402 
Sierra  Madre,  325 
Silao,  363 

Siloam  Springs,  269 
Silver  City,  281 
Simlah,  427 
Skin,  color  of,  as  affected  bv  climate,  49, 

50 
Soil,  composition  of,  24 

humidity  of,  25,  84,  88 
Sorrento,  402 
South  America,  climate  of,  367,  369 

Carolina,  resorts  of,  223 

Park  Springs,  271 
Southern  Pines,  222 
Spa,  388 
Spain,  climate  of,  394 

resorts  of,  395 
Spezia,  400 
Squam,  200 

Steamboat  Springs,  267 
Stomach,  diseases  of,  177 

climatic  changes  for,  178 


470 


INDEX. 


Stomach  diseases,  mineral  waters  in,  178 

Stonehaven,  378 

Strathpeffer,  378 

Strawberry  Valley,  332 

Summerville,  225 

Summit  Soda  Springs,  350 

Sunheat,  36 

as  affecting  germ  life,  81 

general  causes  of,  36 

local  causes  of,  37 
Sunlight,  35 

effects  of,  35 

hours  of,  in  mountain  regions,  455 
Sunstroke,  114 

rarity  of,  in  desert-climates,  165 
in  high  climates,  165 
Surfside,  198 

Sweden,  climatic  advantages  of,  387 
Switzerland,  resorts  of,  413 
Sydney,  430 
Szobrancz,  408 

TACOMA,  354 
Tampa,  229 
Tangier,  423 
Tarasp,  416 
Tarkastad,  425 
Tarma,  373 

Tartary,  steppes  of,  408 
Tasmania,  resorts  of,  432 
Taveres,  229 

Temperament,  in  disease,  120 
Temperature,  as  affecting  the  prevalence 
of  phthisis,  84 

mean  annual,  37 

night-,  455 

sensib"  ,,  32,  62 

variabilitv,  87,  88 
Tenby,  380 

Tennessee,  resorts  of,  230 
Teplitz,  404 

Texas,  resorts  of,  231-235 
Thomasville,  225 
Toluca,  365 
Tombstone,  300 
Topo  Chico  Hot  Springs,  360 
Torquay,  382 
Trequier,  390 
Trieste,  404 
Tropical  regions,  the,  50,  51,  169 

functions  of  the  skin  in,  49 
Trouville,  389 
Tubercle-bacillus,  the,  73,  75 

pure  air  as  affecting,  80 
Tuberculin,  139 
Tuberculosis,  75 


Tuberculosis,  definition  and  nature  of,  75. 

(See  also  Phthisis.) 
Tucson,  296 

UNITED  STATES,  climate  of,  193 
Utah,  resorts  of,  271 
Ute  Park,  261 

YAN  PATTEN  CAMP,  284 
V      Vegetation,  25,  35 
Ventnor,  382 
Vermont,  resorts  of,  206 
Vichy,  391 
Virginia  Beach,  203 

resorts  of,  220 
Voslau,  406 

Voyages,  sea-,  in  neurasthenia,  167 
in  phthisis,  129,  132,  135 

on  the  Great  Lakes,  191 

on  Southern  Seas,  449 

to  Australia,  428 

WAGON  WHEEL  GAP,  271 
Waikiki,  447 
Warm  Springs,  220,  222 
Washington,  resorts  of,  354 
Watch  Hill,  199 
Water,  composition  and  forms  of,  24 

modification  of  climate  by  bodies  of, 
30 
Weather,  21,  183 
Wellington,  433 
Wells  Beach,  196 
West  End,  199 

Virginia,  resorts  of,  220 
Whitby,  385 

White'Sulphur  Springs,  220 
Wiesbaden,  411 
Wiesen,  416 
Wildbad-Gastein,  406 
Wilson's  Peak,  326 
Winds,  effects  of,  upon  phthisis,  89 

general  remarks  on,  27 

influence  of,  in  kidnev  diseases,  171 
Winter  Park,  228 
Wollongong,  431 
Woodhall  Spa,  386 
Woodland  Park,  261 
Wood's  Holl,  197 

yOEK,  196 
1     Yucaipe  Vallev,  330 
Yuma,  298 

yACATECAS,  361 


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